Impaired wound healing

Menke, Nathan B.; Ward, Kevin R.; Witten, Tarynn M.; Bonchev, Danail G.; Diegelmann, Robert F.

doi:10.1016/j.clindermatol.2006.12.005

« Previous Next »Clinics in Dermatology
Volume 25, Issue 1 , Pages 19-25, January 2007

Impaired wound healing

Nathan B. Menke, MD
- Department of Emergency Medicine, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0614, USA
- Department of Biochemistry, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0614, USA
Kevin R. Ward, MD
- Department of Emergency Medicine, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0614, USA
- Department of Biochemistry, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0614, USA
Tarynn M. Witten, PhD
- Center for the Study of Biological Complexity, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University, Richmond, VA 23284-2030, USA
- Department of Mathematics, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University, Richmond, VA 23284-2014, USA
Danail G. Bonchev, PhD
- Center for the Study of Biological Complexity, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University, Richmond, VA 23284-2030, USA
- Department of Mathematics, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University, Richmond, VA 23284-2014, USA
Robert F. Diegelmann, PhD
- Department of Emergency Medicine, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0614, USA
- Department of Biochemistry, VCU Reanimation, Engineering and Shock Center, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0614, USA
- Corresponding author. Department of Biochemistry, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0614, USA.

Abstract

Nonhealing wounds represent a significant cause of morbidity and mortality for a large portion of the population. One of the underlying mechanisms responsible for the failure of chronic wounds to heal is an out-of-control inflammatory response that is self-sustaining. Underappreciation of the inherent complexity of the healing wound has led to the failure of monotherapies, with no significant reduction in wound healing times. A model of the inflammatory profile of a nonhealing wound is one in which the equilibrium between synthesis and degradation has been shifted toward degradation. This review summarizes the current information regarding acute wound healing responses as contrasted to the delayed response characteristic of chronic wounds. In addition, some initial complexity theoretical models are proposed to define and explain the underlying pathophysiology.