School of Chemical and Biomedical Engineering, Nanyang Technological University, 637459, Singapore; NTU Institute of Health Technologies, Interdisciplinary Graduate School, Nanyang Technological University, 639798, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.
Adv Drug Deliv Rev. 2019 Sep-Oct;149-150:2-18. doi: 10.1016/j.addr.2019.03.006. Epub 2019 Apr 6.
Acute wound healing is an orderly process of four overlapping events: haemostasis, inflammation, proliferation and remodelling. A drug delivery system with a temporal control of release could promote each of these events sequentially. However, acute wound healing normally proceeds very well in healthy individuals and there is little need to promote it. In the elderly and diabetics however, healing is often slow and wounds can become chronic and we need to promote their healing. Targeting the events of acute wound healing would not be appropriate for a chronic wound, which have stalled in the proinflammatory phase. They also have many additional problems such as poor circulation, low oxygen, high levels of leukocytes, high reactive oxygen species, high levels of proteolytic enzymes, high levels of proinflammatory cytokines, bacterial infection and high pH. The future challenge will be to tackle each of these negative factors to create a wound environment conducive to healing.
急性伤口愈合是一个有序的过程，包括四个重叠的事件：止血、炎症、增殖和重塑。具有时间控制释放的药物输送系统可以依次促进这些事件。然而，在健康个体中，急性伤口愈合通常进行得非常顺利，几乎不需要促进。然而，在老年人和糖尿病患者中，愈合通常很慢，伤口可能会变成慢性的，我们需要促进它们的愈合。针对急性伤口愈合的各个事件并不适合慢性伤口，因为慢性伤口在促炎阶段停滞不前。它们还存在许多其他问题，如血液循环不良、低氧、白细胞水平高、活性氧水平高、蛋白水解酶水平高、促炎细胞因子水平高、细菌感染和高 pH 值。未来的挑战将是解决这些负面因素，创造有利于愈合的伤口环境。
