Anderson Kristin, Hamm Rose L
Orthopedic Physical Therapy, Therapyworks, Inc., Santa Monica, CA, USA.
Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
J Am Coll Clin Wound Spec. 2014 Mar 24;4(4):84-91. doi: 10.1016/j.jccw.2014.03.001. eCollection 2012 Dec.
The body's response to tissue injury in a healthy individual is an intricate, sequential physiologic process that results in timely healing with full re-epithelialization, resolution of drainage, and return of function to the affected tissue. Chronic wounds, however, do not follow this sequence of events and can challenge the most experienced clinician if the underlying factors that are impairing wound healing are not identified. The purpose of this article is to present recent information about factors that impair wound healing with the underlying pathophysiological mechanism that interferes with the response to tissue injury. These factors include co-morbidities (diabetes, obesity, protein energy malnutrition), medications (steroids, non-steroidal anti-inflammatory drugs or NSAIDs, anti-rejection medications), oncology interventions (radiation, chemotherapy), and life style habits (smoking, alcohol abuse). Successful treatment of any chronic wound depends upon identification and management of the factors for each individual.
健康个体对组织损伤的反应是一个复杂的、循序渐进的生理过程,该过程能实现及时愈合,包括完全重新上皮化、引流消退以及受影响组织功能恢复。然而,慢性伤口并不遵循这一系列事件,如果未识别出影响伤口愈合的潜在因素,即使是经验最丰富的临床医生也可能面临挑战。本文旨在介绍有关影响伤口愈合的因素以及干扰组织损伤反应的潜在病理生理机制的最新信息。这些因素包括合并症(糖尿病、肥胖症、蛋白质能量营养不良)、药物(类固醇、非甾体抗炎药或NSAIDs、抗排斥药物)、肿瘤干预措施(放疗、化疗)以及生活方式习惯(吸烟、酗酒)。任何慢性伤口的成功治疗都取决于对每个个体因素的识别和管理。