The psychobiology of wound healing
Philip N. Murphy in The Routledge International Handbook of Psychobiology, 2018
The findings reviewed above provide compelling evidence that stress can have significant negative effects on the healing of experimental and clinical wounds. The consistency of these findings has prompted further research examining whether stress modifying psychological interventions can influence speed of wound healing. This is a topic of considerable clinical potential, since any intervention that can improve wound healing and recovery could be of clear benefit to patients and health-care systems. There is longstanding evidence that a range of psychological interventions prior to surgery can have beneficial effects on many aspects of post-operative recovery, including pain, mood and length of stay in hospital (Johnston & Vögele, 1993; Powell et al., 2016). Although some of these studies have also shown positive effects on various physiological parameters, there do not appear to be many that have specifically investigated wound healing outcomes. However, there are a small number of quite recent clinical and experimental studies that have investigated whether a stress-modifying intervention can enhance wound healing and whether any such effects are mediated by immune or neuroendocrine processes. This section provides a brief overview of these studies.
Soft and Hard Tissue Repair
John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie in Basic Sciences Endocrine Surgery Rhinology, 2018
Wound healing has been divided into four overlapping stages: haemostasis, inflammation, proliferation and remodelling. However, this complex process is by no means constant, with genetics (susceptibility to abnormal scarring), age, site, tension, nutrition and disease all very important influencing factors. A wound is ‘healed’ when: connective tissue repair and complete re-epithelialization have occurredskin cover has been resorted with scar tissue without the necessity of drains or dressings. When the process of wound healing fails to occur in an orderly and timely fashion, wounds become chronic and non-healing, requiring continued management by drainage and dressing.1
The Use of Placenta-Derived Cells in Inflammatory and Fibrotic Disorders
Ornella Parolini, Antonietta Silini in Placenta, 2016
Fibrosis has been described as an inappropriate and uncontrolled wound healing response. In excess, fibrosis is pathological and can critically compromise organ function. For example, fibrotic diseases such pulmonary fibrosis, liver cirrhosis, and chronic kidney disease are leading causes of morbidity and mortality worldwide. They have the potential to affect multiple tissues and organ systems. Wound healing is essentially a process where dead or damaged cells are replaced after injury. This process has two major phases that may occur in tandem: a regenerative phase where the dead or damaged cells are replaced by healthy cells of the same cell types, and a fibrotic phase where connective tissue replaces the parenchyma. These phases, although usually beneficial, can become pathogenic when either is uncontrolled. If substantial amounts of extracellular matrix (ECM) remodeling takes place, this can eventuate in irreversible scarring and potentially culminate in organ failure, whereas uncontrolled regeneration may result in neoplasia.
Transnasal drainage prevents surgical cavity related complications in transoral robotic surgery resected parapharyngeal space tumors
Published in Acta Oto-Laryngologica, 2023
Chunping Wu, Chengzhi Xu, Huiching Lau, Xiaoling Shi, Quan Liu, Liang Zhou, Lei Tao
This study introduced a novel surgical approach for drainage after TORS resection of PPS tumors. The present series represents one of the largest to date. However, the sample size is relatively low for statistical analysis. In addition, there were differences in preoperative age distribution between the two groups. Because we were not very satisfied with the overall HGSI and HGSC of patients with TORS resected PPS tumors we had done previously, we tried to improve it. In the last eight patients, we used this drainage method and did find obvious clinical efficacy. But we can’t choose the patient’s age. Fortunately, there was no significant difference in other preoperative clinical features between the two groups. We will use this drainage method for more patients in our subsequent work. In terms of hospitalization time, there was no significant difference between the two groups. However, hospitalization time was not the focus of this study. The main purpose of this study was to help patients achieve optimal wound healing.
Enhanced healing efficacy of an optimized gabapentin-melittin nanoconjugate gel-loaded formulation in excised wounds of diabetic rats
Published in Drug Delivery, 2022
Hani Z. Asfour, Nabil A. Alhakamy, Osama A. A. Ahmed, Usama A. Fahmy, Shadab Md, Mohamed A. El-Moselhy, Waleed Y. Rizg, Adel F. Alghaith, Basma G. Eid, Ashraf B. Abdel-Naim
The defensive role of the dermal layer as a first-line in exhibiting protection against pathogens or against physical injury is well established (Strecker-McGraw et al., 2007). A healthy and integrated dermal layer performs the crucial role of maintaining check and balance in the human body. When minor wear-tear occurs, the skin automatically heals itself, and the damaged layer sheds off (Tottoli et al., 2020). However, when skin integrity gets compromised in response to multiple traumas, coexisting disease conditions such as diabetes, or in a stressed condition, the healing capacity gets significantly affected, and chronic cutaneous wounds persist (Qing, 2017). The ideal definition of dermal/cutaneous wound refers to the loss of anatomical and functional integrity of the epidermis, dermis and endodermis. In a normal physiological condition, the cutaneous wound healing begins immediately and may last for months, depending on multiple factors (Li et al., 2022a). The cost of wound treatment has been expected to increase significantly over the next decade because of diabetes and the modern lifestyle (Velnar et al., 2009). Nevertheless, the wound healing mechanism is a dynamic and complex process that involves multiple factors such as the role of inflammation, oxidative stress, apoptosis, and fibrosis (Roy et al., 2022). The precise wound healing mechanism comprises a role of growth factors such as transforming growth factor-beta (TGF-β), cytokines such as transforming growth factor beta (TNF-α), interleukins (ILs), angiogenic factors such as vascular endothelial growth factor (VEGF) and fibrotic factors (Wan et al., 2021).
Granzyme B as a therapeutic target: an update in 2022
Published in Expert Opinion on Therapeutic Targets, 2022
Alexandre Aubert, Michael Lane, Karen Jung, David J. Granville
Wound healing is a multifactorial, physiological process that occurs in the human body through four overlapping sequential phases: hemostasis, inflammation, proliferation, and remodeling. To achieve optimal recovery of tissue function, integrity, and elasticity, these four phases need to be temporally and spatially regulated in order to resolve the wound in a timely manner. Numerous factors such as smoking, diet, obesity, and aging can impact wound healing, resulting in altered tissue function, scarring, fibrosis, or delayed healing [1]. Among the myriad of factors involved, careful consideration has been given to proteases as central mediators of extracellular matrix (ECM) degradation and remodeling in wound healing. While many research groups have previously focused on the matrix metalloproteinase (MMP) superfamily in the context of skin wound healing [2], a role for serine proteases such as granzyme B (GzmB) has recently garnered the attention of the scientific community [3].