Reviewing Choices of Topical Corticosteroids for Modulating Inflammatory Response in Chronic Wound Management

Abstract

Chronic wounds, characterized by prolonged inflammatory responses and impaired healing, pose a significant challenge in clinical practice. This review explores the potential of topical glucocorticosteroids in modulating inflammation and promoting wound healing in chronic wounds. We delve into the mechanisms underlying chronic inflammation, emphasizing the crucial role of proinflammatory cytokines, reactive oxygen species, and impaired cellular responses. Topical corticosteroids, known for their anti-inflammatory, anti-mitotic, and immunosuppressive properties, emerge as promising candidates to influence the transition from the inflammatory to the proliferative phase of wound healing. The discussion encompasses the mechanisms of action of topical corticosteroids, focusing on their binding to glucocorticoid receptors, inhibition of inflammatory mediators, and potential adverse effects. We address the importance of selecting the appropriate corticosteroid based on potency, application duration, and patient-specific factors. Various formulations, such as ointments, creams, gels, and foams, are evaluated in terms of their advantages and drawbacks in wound management. While acknowledging the recognized efficacy of topical corticosteroids in chronic wound management, we highlight concerns regarding their standalone use, such as immunosuppression and potential infection masking. Furthermore, we explore the integration of retinoids with corticosteroids as a novel approach to mitigate unwanted effects and enhance wound healing outcomes. Despite emerging studies on combination therapies, careful consideration and clinical judgment remain paramount for further development and implementation. In conclusion, this comprehensive review provides insights into the potential of topical corticosteroids in chronic wound management. As research in this field progresses, the integration of innovative therapeutic strategies, including retinoids, holds promise for improving outcomes in the challenging realm of chronic wound care. Keywords: topical corticosteroids, chronic wound management, inflammation modulation, immunomodulation, retinoids, wound healing outcomes.