Biologic Characteristics Of Acute And Chronic Wounds

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It was always understood that understanding the basic mechanism of wound healing is very important to treat a wound. In recent times advances in understanding the basic mechanism of wound healing have brought to the forefront optimal treatments of chronic wounds.

If you talk to a professional they will let you know that the exuded fluid from a wound bed is not inert. This fluid has biologic and chemical properties that may either hasten or prolong the healing of a wound.

There has been limited success to find the cause of a specific wound when research trials that included topical administration of specific growth factors, like platelet derived growth factor, pressure, venous, and diabetic wounds were combined with optimal treatment.

Date from experiments suggests that growth factors are multifunctional. These growth factors either facilitate or impede wound healing. This depends on two things, the wound bed matrix and cellular conditions.

Exudates from an acute wound have a lot of growth factors. These specifically include platelet derived growth factor, fibroblast growth factor, and epithelial growth factor. These help promote the proliferation of fibroblasts, keratinocytes, and endothelial cells. This is in case of both in-vitro and in-vivo studies.

There are finite organized inflammatory stages for proteolytic and fibrinolytic agents so as to break down debris in an acute wound.

Concentration of these is decreased subsequently so as to set up the proliferation and re-epithelialization of cells.

Also enzymes called endogenous proteolytic and fibrinolytic break-down the components of the wound bed. The resultant which is produced acts as chemotactic messengers. This attracts more inflammatory cells which hasten the re-epithelialization process.

On the other hand exudate from a chronic wound has different composition from an acute wound. Studies show that this exudate shows decreased cellular mitogenic activity in the chronic wound bed.

It is possible that this characteristic of the exudates could be associated with higher concentrations of matrix metalloprotease proenzymes. Metalloprotease proenzymes help in degrading the wound matrix necessary for optimal healing.

There is usually a competing and prolonged stage of inflammation in a chronic wound. This stage inhibits a nascent proliferative stage.

In conclusion we can then say that the key to healing a chronic wound is that we not only balance moisture levels present in the wound bed but also need to sequester compounds in chronic wound exudate as these could prove to be a barrier to normal healing.
A moisture balanced wound environment is provided by using and applying properly the newer generation wound dressings.

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