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1.
Recent investigation into the mechanisms of wound healing has indicated the interaction of many substances, including several growth factors. The activity of platelet-derived growth factor (PDGF) and transforming growth factor beta (TGF-β), are best defined. Both factors are secreted primarily from the alpha granules of platelets, but also from activated macro-phages and fibroblasts. Investigation implicates the platelet as the initiator of wound healing, secreting PDGF, TGF-β, and other factors that are chemotactic for monocytes, macrophages, and fibroblasts. Although their mode of action and degree of effect are different, both PDGF and TGF-β increase the collagen content and early rate of gain of strength in wounds in normal and compromised tissue. In normal tissue, however, there is no long-term effect on wound outcome. The use of exogenous growth factors offers potential for chemical manipulation of the healing wound, particularly in tissues that are compromised, or where healing is abnormal.  相似文献   

2.
Wound healing in mammals occurs by a process of regeneration and scar tissue production. In particular, epithelium has marked regenerative capacity. Healing is an active process from the moment the wound is inflicted--a "lag" phase does not exist. In surgery the important factors affecting wound healing are protein deficiency, uremia, corticosteroids, and local tissue injury. Stimulants to wound healing are not available for clinical application.  相似文献   

3.
Principles of wound healing   总被引：2，自引：0，他引：2  
Wound healing can be divided into immediate (zero to 1 hour), early (1 to 24 hours), intermediate (1 to 7 days), and late (greater than 7 days) stages. Many physical and physiologic events occur simultaneously and sequentially during these stages to produce the final wound scar. The processes of skin retraction, scab formation, would debridement, wound contraction, epithelial migration and proliferation, fibroplasia, and collagen maturation all must occur for healing to be successful. Many factors affect the size and shape of the resulting scar, including anatomic location and skin tension forces, systemic condition of the patient, blood supply to the wound, nutritional factors, environmental temperature, the presence of systemic drugs, wound infection, motion, wound oxygen gradient, wound moisture, and bandaging. Ideally, each of the factors would occur at a level compatible with optimal healing, but, in many clinical cases, one or more factors compromise normal, rapid healing. When we intervene with therapy, we probably adversely affect another factor in healing, while trying to correct the factor that is out of balance. In these decisions, the effects of our treatment on wound healing should be considered. The trade-off should be weighed and the treatment pursued only as long as necessary to allow healing to progress; then it should be discontinued or changed. With these considerations, it is hoped that we can attain healing at the most rapid physiologic rate.  相似文献   

4.
In all species of mammals, the stages of wound healing are the same, and both host factors and wound characteristics affect how wounds heal. The basic principles of wound care in ferrets, such as lavage, bandaging, and surgical closure, are similar to those in other species; however, knowledge of ferrets' anatomy and pathophysiology, as well as skin conditions commonly seen in ferrets, will help ensure proper wound healing.  相似文献   

5.
There are a plethora of topical and systemic medications available to the veterinary practitioner today that aid the wound healing process. Some of these help to maintain a moist environment. Others increase growth factors, provide local energy sources, control infection, provide for debridement, increase wound blood flow and temperature, or reduce wound edema. Modern wound care requires that the proper products(s)be used, depending on the condition of the wound and the phase of wound healing. This article discusses various wound care products and provides guidelines on their use.  相似文献   

6.
In summary, corneal wound healing is a complex phenomenon that involves interplay between the cellular elements of the cornea, numerous soluble factors, and the constituents of the ECM. Unfortunately, many studies that demonstrate marked alteration on cell behavior in vitro and even in in vivo experiments are often not helpful in the diseased patient, as shown by the results of careful clinical trials. Future work that addresses the complex milieu of the corneal wound healing environment by addressing the interaction of many of these factors will be more likely to be successful than seeking a single agent that will enhance wound healing in all situations.Modulation of wound healing processes by the application of topical therapeutic agents is, however, an expanding field of study sure to produce clinically significant improvements in the management of veterinary patients with corneal defects. The judicious use of topical cytoactive compounds has a place in the clinician's armamentarium integrated into a therapeutic plan that decreases the mechanical stresses imposed on the wound bed as well as removal of any underlying inciting cause.  相似文献   

7.
Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds.  相似文献   

8.
Wound healing is a biologically complex cascade of predictable overlap-ping events and is a natural restorative response to tissue injury. The biologic process for wound healing is the same for all wounds, although the specific mechanisms may vary. This article reviews the wound heal-ing process, discussing factors that may delay normal healing progression and potential modalities and treatments to aid healing.  相似文献   

9.
Topical treatments in equine wound management.   总被引：1，自引：0，他引：1  
Wound repair is a complex series of coordinated events regulated by a delicately orchestrated cascade of cytokines and growth factors that restore the structural integrity of damaged tissue. Manipulation of the growth factor profile or wound environment through topical application of therapeutic agents could positively influence the rate and quality of wound repair. Transforming growth factor-beta,platelet-rich plasma, activated macrophage supernatant, and growth hormone are sources of mediators that may facilitate wound healing. Solcoseryl, ketanserin, tripeptide- and tetrapeptide-copper complexes, maltodextrin, live yeast cell derivative, corticosteroids,aloe vera, acemannan, phenytoin, honey, sugar, and maggots may modify the wound environment and promote repair. The process of wound healing is complex, however, and it is currently unknown whether any one agent can ameliorate all issues of repair or cover all vulnerabilities of impaired wound healing.  相似文献   

10.
Impaired wound healing is an important problem; retardation of healing may be induced by endogenous and/or exogenous factors and treatments capable of ameliorating these effects are needed. The effects of solutions containing light ichthyol or povidone iodine, of ointments containing zinc oxide (ZO) and/or cod liver oil (CLO), and of a polyurethane-hydrogel foam wound dressing were examined on healing of full-thickness murine skin wounds impaired by systemic dexamethasone. The effects of the ointments were also studied on murine skin ulceration induced by subcutaneous sodium dodecyl sulphate solution. Light ichthyol at 1% and 2% but not at 5% and 10%, povidone iodine at 1% and the foam accelerated impaired healing. The ointments containing ZO or CLO accelerated healing of impaired full-thickness wounds and of ulcerated skin; ZO and CLO were synergistic. These studies demonstrate the value of murine models in the evaluation of agents employed in veterinary wound dressings.  相似文献   

11.
The contribution of wound contraction to wound closure determines the speed of second intention wound healing and it has been shown that significant differences exist with regard to both contraction and inflammatory response between horses and ponies and between various areas of the body. In this study, the contraction capacity of fibroblasts from limbs and buttocks of 4 Dutch Warmblood horses and 4 Shetland ponies was studied in vitro, in order to determine whether differences in wound contraction are due to differences in the inherent contraction capacity of the fibroblasts or to differences in tissue environmental factors, such as the inflammatory response. Fibroblasts were harvested from subcutaneous tissue, cultured and then suspended in both floating and anchored collagen gels. Contraction capacity was assessed by measuring the decrease in area of the floating gels and by measuring the microforces generated in the anchored gels using a custom-built measuring device. In the floating gels, no difference existed in the contraction capacity of fibroblasts from horses and ponies, or from limbs and buttocks. In the anchored gels, no differences existed between horse and pony fibroblasts, but the fibroblasts from the limbs started to contract significantly sooner and produced significantly higher forces than those from the buttocks. It is concluded that the in vivo differences in wound contraction between horses and ponies and between different sites of the body are not caused by differences in the inherent contraction capacity of fibroblasts. The in vitro differences between fibroblasts from limbs and buttocks are thought to be due to the lower proliferation rate and the longer culture time of the fibroblasts originating from the limbs, because mature fibroblasts can develop higher contraction forces than immature fibroblasts. This means that tissue environmental factors, such as cytokine profiles during the inflammatory response, determine the extent of contraction during wound healing. Further research should be directed towards the role of the inflammatory response in wound healing.  相似文献   

12.
Successful wound management requires appropriate evaluation of the wound at the time of initial physical examination, an all throughout the healing process. Factors affecting wound healing need to be identified though a complete patient history and addressed to ensure proper healing. The clinician must have current knowledge of topical medications and bandages available and their clinical applications according to the stage of healing. It is essential to remember that wounds are painful; therefore, analgesics should be administered to render the animal pain-free during wound cleaning, debridement, bandaging, and surgical procedures.  相似文献   

13.
Immune responses have a crucial role during the wound healing process in cutaneous leishmaniasis (CL). However, there are several paradoxes in immunity against CL. On the one hand, regulatory cytokines interleukin (IL)-10 and transforming growth factor beta (TGF-β) increase susceptibility to CL through suppression of several proinflammatory cytokines that require for defense against CL. On the other hand, these cytokines play a pivotal role in the acceleration of wound healing process. This review discusses about the dual role of IL-10 and TGF-β during the wound healing process and immunity against CL to offer a new insight about wound healing in CL.  相似文献   

14.
Background A two‐part study examined wound healing and contraction occurring after mulesing and two alternative methods of preventing breech flystrike in sheep. Objective To quantify wound healing using a scoring system and to assess the contractility of the wound bed of the breech after mulesing, cetrimide‐intradermal treatment and application of clips. Method The study group of 30 mulesed, 30 cetrimide‐intradermal treated, 30 control and 10 clip‐treated sheep were humanely killed at six time points from 3 to 47 days after each treatment. Wound healing post treatment was assessed using a scoring system, and contractility was assessed by the quantification of myofibroblast expression. Statistical analyses allowed comparisons of temporal wound healing and contraction between treatment groups. Results Mulesing wounds healed faster in the first 11 days, but by 19 days wound healing was similar between the mulesing and cetrimide‐intradermal groups. By 32 days, all three treatment groups had similar wound healing scores. There was greater myofibroblast expression in the mulesing group in the first 11 days after treatment, but by 19 days expression was similar in both the mulesing and cetrimide‐intradermal groups. The clip group had significantly less myofibroblast expression from 32 days after treatment. Conclusion Wound healing is initially most rapid after mulesing, but there are similar wound healing scores in the mulesing and cetrimide‐intradermal treatment groups by 19 days. Both mulesing and the cetrimide‐intradermal treatment induce a similar amount of wound bed contraction, with less contraction observed after application of clips.  相似文献   

15.
New materials have allowed the role of the bandage to expand from passive protector to active participant in the wound healing process. By building a bandage that maintains a moist wound environment,the veterinarian uses the patient's own wound healing mechanisms to provide selective autolytic debridement, speed granulation and epithelialization, decrease infection, and increase patient comfort. A large variety of primary dressings are available to custom-make a bandage appropriate to each stage of wound healing. This article discusses the principles of moist wound healing, selection and application of primary dressings, special considerations for applying and changing bandages and splints, and prevention of bandage complications.  相似文献   

16.
Three sets of paired circular and square full-thickness skin wounds were made on the dorsum of the metacarpus (n = 48) of 8 horses. Each wound was 6.25 cm2 in area. The wounds were treated topically with an ointment, nonadherent dressing, and bandaged with a snug elastic wrap. Wounds were photographed every other day until healing was complete. Wound areas were measured and exponential and linear wound healing models were applied to the wound healing data generated. Wound healing variables measured for each wound were: number of days to healing, maximal size attained, rate of wound contraction (calculated by use of first-order and linear models), final wound size, and percentage of wound that healed by contraction. The exponential model fit the data significantly better than the linear model. The maximal size attained by circular wounds was significantly smaller than the maximal size attained by square wounds. Wound shape did not influence the rate of wound healing. On the basis of our findings, conversion of circular defects to square defects would not speed wound healing.  相似文献   

17.
Regardless of the species involved, wound healing follows a predictable course of overlapping phases. In spite of these commonalities, significant species differences in cutaneous wound healing have been uncovered in the Equidae and, more recently, between the dog and cat. It has also recently been shown that the subcutaneous tissues play an important supporting role in cutaneous wound healing, which may help to ex-plain healing differences between cats and dogs. These discoveries may improve veterinarians' understanding of problem wound healing in the cat and, hopefully, lead to better strategies for wound management in this sometimes troublesome species.  相似文献   

18.
The equine practitioner can positively influence wound healing by dispensing appropriate treatment in the first few hours after injury.Positive actions in the early period include hemostasis, meticulous cleansing and debridement of the wound, the use of effective but nonirritating products to disinfect the wound, closure (if indicated)with minimal tension on the suture line, the judicious use of drains,and ensuring adequate tetanus protection. Furthermore, a thorough assessment of the wound and the patient in the initial period after trauma provides pertinent information on prognosis. Finally,good communication and cooperation among all involved parties are necessary to ensure that everyone understands the factors involved and the potential for a successful outcome.  相似文献   

19.
Bone- and non-bone-derived growth factors and effects on bone healing.   总被引：1，自引：0，他引：1  
In the future, it may be possible to manipulate the fracture site with exogenous growth factors to allow successful union of the bone ends without additional surgery. The complex interaction of growth factors, the timing of their appearance and disappearance at the wound site, and the concentrations necessary to achieve specific effects must be studied more thoroughly. For growth factors to find widespread clinical use, there must be evidence that healing is enhanced. It may be difficult to enhance the healing of fresh fractures in normal animals, and it may also be difficult to demonstrate the healing of nonunion fractures. Because of the great variability in fractures of clinical patients, studies designed to determine the effect of growth factors on bone healing must be carefully designed with appropriate attention given to randomizing patients based on the risk of delayed healing and other patient characteristics.  相似文献   

20.
OBJECTIVE: To describe the macroscopic features of first and second intention cutaneous wound healing in the cat and compare with the dog. STUDY DESIGN: Experimental study. ANIMALS: Domestic shorthaired cats (6) and beagle dogs (6). METHODS: Square, open cutaneous wounds created on the dorsal aspect of the thorax were evaluated for 21 days for temporal and spatial development of granulation tissue, wound contraction, epithelialization, and total healing. To evaluate first intention healing, breaking strength of sutured linear cutaneous wounds was measured at 7 days post-wounding. Laser-Doppler perfusion imaging was used to measure cutaneous perfusion. RESULTS: First intention healing: sutured wounds in cats were only half as strong as those in dogs at day 7 (0.406 versus 0.818 kg breaking strength). Second intention healing: cats produced significantly less granulation tissue than dogs, with a peripheral, rather than central distribution. Wound epithelialization and total wound healing (total reduction in open wound area from contraction and epithelialization) were greater for dogs than for cats over 21 days. Wound contraction on day 7 was greater for dogs, but not on day 14 or 21. Cutaneous perfusion was initially greater for dogs than for cats, but no differences were detected after day 7. CONCLUSIONS: Significant, previously unreported differences in cutaneous wound healing exist between cats and dogs. In general, cutaneous wounds in cats are slower to heal. Cats and dogs also appear to use different mechanisms of second intention healing. In cats wounds close mainly by contraction of the wound edges, whereas in dogs wounds close more from central pull, and epithelialization. CLINICAL RELEVANCE: Surgeons should view the cat as a unique species, which presents its own special challenges in wound healing, and should take this into account when planning treatment of feline wounds, either by primary closure, or by second intention healing.  相似文献   

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