Department of Plastic Surgery, Level 5, Ninewells Hospital, Dundee, DD1 9SY, UK.
Int Wound J. 2010 Apr;7(2):107-13. doi: 10.1111/j.1742-481X.2010.00663.x.
Systemic diseases are intrinsic factors that alter and may impair the wound healing process. Cachexia is a manifestation of systemic, often chronic, diseases and is characterised by systemic inflammation, appetite suppression and skeletal muscle wasting. Anorexia in cachectic states is commonly associated with malnutrition. Malnutrition may cause impaired healing. Therefore, it would follow that cachexia could influence wound healing because of reduced food intake. However, the lack of response to measures to reverse cachexia, such as supported nutrition, would suggest that a direct causal link between anorexia and weight loss in cachexia is too simple a model. To date, there is no published literature that examines the role of cachexia in human wound healing specifically. This article aims to demonstrate that cachexia is an intrinsic factor in wound healing. The role of the common mediators in wound healing and in cachexia are compared - specifically inflammation, including the nitric oxide synthase pathway, collagen deposition and reepithelialisation.
系统性疾病是改变和可能损害伤口愈合过程的内在因素。恶病质是系统性疾病的表现，通常是慢性的，其特征是全身炎症、食欲抑制和骨骼肌消耗。恶病质状态下的厌食症通常与营养不良有关。营养不良可能导致愈合受损。因此，恶病质可能会因为摄入食物减少而影响伤口愈合。然而，支持性营养等逆转恶病质的措施缺乏反应，这表明厌食症和恶病质体重减轻之间的直接因果关系过于简单。迄今为止，没有发表的文献专门研究恶病质在人类伤口愈合中的作用。本文旨在证明恶病质是伤口愈合的内在因素。比较了伤口愈合和恶病质中常见介质的作用——特别是炎症，包括一氧化氮合酶途径、胶原蛋白沉积和再上皮化。
