Miller Mary-Clare, Nanchahal Jagdeep
Kennedy Institute of Rheumatology, Imperial College, London, UK.
BioDrugs. 2005;19(6):363-81. doi: 10.2165/00063030-200519060-00004.
Cutaneous wounds inevitably heal with scars, which can be disfiguring and compromise function. In general, the greater the insult, the worse the scarring, although genetic make up, regional variations and age can influence the final result. Excessive scarring manifests as hypertrophic and keloid scars. At the other end of the spectrum are poorly healing chronic wounds, such as foot ulcers in diabetic patients and pressure sores. Current therapies to minimize scarring and accelerate wound healing rely on the optimization of systemic conditions, early wound coverage and closure of lacerations, and surgical incisions with minimal trauma to the surrounding skin. The possible benefits of topical therapies have also been assessed. Further major improvements in wound healing and scarring require an understanding of the molecular basis of this process. Promising strategies for modulating healing include the local administration of platelet derived growth factor (PDGF)-BB to accelerate the healing of chronic ulcers, and increasing the relative ratio of transforming growth factor (TGF)beta-3 to TGFbeta-1 and TGFbeta-2 in order to minimize scarring.
皮肤伤口不可避免地会留下疤痕，这些疤痕可能会影响美观并损害功能。一般来说，损伤越大，疤痕就越严重，不过基因组成、部位差异和年龄也会影响最终结果。过度疤痕形成表现为增生性疤痕和瘢痕疙瘩。另一极端情况是愈合不良的慢性伤口，如糖尿病患者的足部溃疡和压疮。目前减少疤痕形成和加速伤口愈合的治疗方法依赖于优化全身状况、早期伤口覆盖和撕裂伤及手术切口的闭合，同时对周围皮肤造成最小的创伤。也评估了局部治疗的潜在益处。伤口愈合和疤痕形成方面的进一步重大进展需要了解这一过程的分子基础。调节愈合的有前景的策略包括局部应用血小板衍生生长因子（PDGF）-BB以加速慢性溃疡的愈合，以及增加转化生长因子（TGF）β-3与TGFβ-1和TGFβ-2的相对比例以尽量减少疤痕形成。
