Menke Marie N, Menke Nathan B, Boardman Cecelia H, Diegelmann Robert F
Department of Obstetrics and Gynecology, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA.
Gynecol Oncol. 2008 Nov;111(2 Suppl):S87-91. doi: 10.1016/j.ygyno.2008.07.052. Epub 2008 Oct 1.
Non-healing wounds represent a significant cause of morbidity and mortality for a large portion of the adult population. Wounds that fail to heal are entrapped in a self-sustaining cycle of chronic inflammation leading to the destruction of the extracellular matrix. Among cancer patients, malnutrition, radiation, physical dehabilitation, chemotherapy, and the malignancy itself increase the likelihood of chronic wound formation, and these co-morbidity factors inhibit the normal wound healing process. Current wound treatments are aimed at some, but not all, of the underlying causes responsible for delayed healing of wounds. These impediments block the normal processes that allow normal progression through the specific stages of wound healing. This review summarizes the current information regarding the management and treatment of complex wounds that fail to heal normally and offers some insights into novel future therapies [Menke N, Ward KR, Diegelmann R. Non-healing wounds. Emerg Med Rep 2007; 28(4).,Menke NB, Ward KR, Witten TM, Bonchev DG, Diegelmann RF. Impaired wound healing. Clin Dermatol 2007;25:19-25].
对于很大一部分成年人群体而言,难愈合伤口是发病和死亡的一个重要原因。无法愈合的伤口陷入了导致细胞外基质破坏的慢性炎症自我维持循环中。在癌症患者中,营养不良、放疗、身体机能衰退、化疗以及恶性肿瘤本身都会增加慢性伤口形成的可能性,而这些合并症因素会抑制正常的伤口愈合过程。当前的伤口治疗针对的是导致伤口愈合延迟的部分而非全部潜在原因。这些障碍阻断了使伤口愈合能正常历经特定阶段的正常进程。本综述总结了有关难正常愈合的复杂伤口管理与治疗的当前信息,并对未来的新型疗法提供了一些见解[Menke N, Ward KR, Diegelmann R. 难愈合伤口。《急诊医学报告》2007年;28(4).,Menke NB, Ward KR, Witten TM, Bonchev DG, Diegelmann RF. 伤口愈合受损。《临床皮肤病学》2007年;25:19 - 25] 。