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伤口愈合受损:预测、预防和个性化医学中多专业考量的事实与假说

Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine.

作者信息

Avishai Eden, Yeghiazaryan Kristina, Golubnitschaja Olga

机构信息

Rappaport Faculty of Medicine, Technion, Haifa, Israel.

Radiological Clinic, Medical Faculty, Friedrich-Wilhels-University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.

出版信息

EPMA J. 2017 Mar 3;8(1):23-33. doi: 10.1007/s13167-017-0081-y. eCollection 2017 Mar.

Abstract

Whereas the physiologic wound healing (WH) successfully proceeds through the clearly defined sequence of the individual phases of wound healing, chronic non-healing wounds/ulcers fail to complete the individual stages and the entire healing process. There are many risk factors both modifiable (such as stress, smoking, inappropriate alcohol consumption, malnutrition, obesity, diabetes, cardio-vascular disease, etc.) and non-modifiable (such as genetic diseases and ageing) strongly contributing to the impaired WH. Current statistics demonstrate that both categories are increasingly presented in the populations, which causes dramatic socio-economic burden to the healthcare sector and society at large. Consequently, innovative concepts by predictive, preventive and personalised medicine are crucial to be implemented in the area. Individual risk factors, causality, functional interrelationships, molecular signature, predictive diagnosis, and primary and secondary prevention are thoroughly analysed followed by the expert recommendations in this paper.

摘要

生理性伤口愈合(WH)能够通过伤口愈合各个阶段明确的顺序顺利进行,而慢性不愈合伤口/溃疡则无法完成各个阶段及整个愈合过程。存在许多可改变的风险因素(如压力、吸烟、不当饮酒、营养不良、肥胖、糖尿病、心血管疾病等)和不可改变的风险因素(如遗传疾病和衰老),这些因素会极大地导致伤口愈合受损。当前统计数据表明,这两类因素在人群中的出现频率越来越高,给医疗保健部门乃至整个社会带来了巨大的社会经济负担。因此,预测、预防和个性化医学的创新理念对于该领域的实施至关重要。本文将对个体风险因素、因果关系、功能相互关系、分子特征、预测性诊断以及一级和二级预防进行深入分析,并给出专家建议。

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