E-Book 3rd Congress
- A brief overview of effective and interfering factors in the healing process of surgical wounds and chronic wounds
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Shabnam Akbari,1,*
- Introduction: Background and purpose: Today, reducing pain and rapid healing of surgical wounds (acute) and chronic wounds are discussed by researchers. Wound healing is the process of structural and functional reconstruction of injured tissues. Damage to the skin can lead to contamination and disruption of the body's homeostasis. When an acute injury occurs, extensive cell migration, proliferation, and differentiation, synthesis of extracellular matrix components, scar formation, and restoration of blood flow and oxygen supply to the tissue are part of They are a complex adjustment of improvement and restoration. Wound healing, a natural biological process in the human body, is achieved through four precise and highly programmed stages: homeostasis, inflammation, proliferation, and regeneration. For a wound to heal successfully, all four steps must occur in the proper order and time frame. However, chronic wounds do not follow this sequence of events and can challenge the most experienced physician if underlying factors interfere with wound healing are not identified. The purpose of this article is to provide recent information on factors that interfere with the response to tissue injury, impair wound healing, and factors that accelerate healing.
- Methods: The article is a review and does not have materials and methods
- Results: Recent findings: Carbohydrates, along with fats, are the main source of energy in the wound healing process for surgical patients or sick patients. Protein is one of the most important nutritional factors affecting wound healing. Protein deficiency can impair capillary formation, fibroblast proliferation, proteoglycan synthesis, collagen synthesis, and wound regeneration. Vitamins C (L-ascorbic acid), A (retinol), and E (tocopherol) have strong antioxidant and anti-inflammatory effects. Vitamin C deficiency leads to impaired healing and is associated with reduced collagen synthesis and fibroblast proliferation, reduced angiogenesis, and increased capillary fragility. Wound oxygenation status is a key factor in wound healing outcomes. Oxygen is intricately involved in numerous biological processes, including cell proliferation, angiogenesis, and protein synthesis, which are required to restore function and tissue integrity. Wound tissue hypoxia is usually greater in the center of the wound. Hypoxemia, caused by vascular dysfunction, is a key factor limiting wound healing. Correction of hypoxemia through the administration of supplemental oxygen (O2) can have a significant beneficial effect on wound healing. Many drugs, such as those that interfere with clot formation or platelet function, or inflammatory responses and cell proliferation, can affect wound healing. These agents include common medications (glucocorticoid steroids, non-steroidal anti-inflammatory drugs, or NSAIDs) that have a significant effect on wound healing. Systemic glucocorticoids (GC), often used as anti-inflammatory agents, are well known to inhibit wound healing through anti-inflammatory effects and suppression of wound cellular responses, including fibroblast proliferation and collagen synthesis. Most chemotherapy drugs are designed to induce rapid cell division and angiogenesis and therefore inhibit many pathways that are relevant to wound healing. These drugs inhibit the synthesis of DNA, RNA, or protein and thus reduce fibroplasia and neovascularization of wounds.
- Conclusion: Conclusion: Nutritional needs of wounds are complex and complex nutritional support is useful for healing acute and chronic wounds. Proteins, carbohydrates, arginine, glutamine, polyunsaturated fatty acids, vitamin A, vitamin C, vitamin E, magnesium, copper, zinc, and iron play a significant role in wound healing, and their deficiency affects wound healing. Both the absence and presence of oxygen affect wound healing. New therapeutic approaches that take advantage of cellular hypoxia sensing and response mechanisms and recreate the precise application of oxygen therapy in hypoxic tissue areas, as well as therapeutic approaches targeting oxygen and redox sensing signaling pathways, are very promising. Consequently, the successful treatment of any acute or chronic wound depends on the identification and management of factors for each individual.
- Keywords: Wound healing, biological biomolecules, oxygen, drugs, chemotherapy