The use
of antioxidants in healing
Martin A
Warner-Lambert Company, Morris Plains, New Jersey
07950, USA.
Dermatologic Surgery (USA), 1996, 22/2
(156-160)
BACKGROUND. Antioxidants enhance the healing of
infected and noninfected wounds by reducing the
damage caused by oxygen radicals.
OBJECTIVE. Studies were conducted to determine
if the CRT components (vitamin E, sodium pyruvate,
and specific fatty acids) could synergistically
enhance healing.
METHODS. In vitro and in vivo studies were used
to assess the effect of various combination of CRT
components.
RESULTS. CRT reduced oxidative damage to
keratinocytes and monocytes exposed to ultraviolet
light and toxic chemicals and provided protection
to human subjects exposed to ultraviolet
irradiation. CRT dramatically facilitated healing
of infected and noninfected wounds. In
herpes-infected guinea pigs, CRT reduced vaginal
viral lesion development, severity, and duration,
thus facilitated healing of the lesions. CRT also
reversed doxorubicin cytotoxicity in monocytes and
reversed doxorubicin-impaired wound healing in
rats.
CONCLUSION: The CRT colly to enhancing healing
of injuries.
Differential regulation of macrophage
arginine metabolism: a proposed role in wound
healing.
Shearer JD; Richards JR; Mills CD; Caldwell
MD
Department of Surgery, University of Minnesota,
Minneapolis 55455, USA.
Am J Physiol (United States) Feb 1997, 272 (2 Pt
1) pE181-90
Nitric oxide (NO) and ornithine, products of NO
synthase or arginase, respectively, have opposing
biological activities. The effect of mediators of
leukocyte activation and inhibition on arginine
metabolism of resident mouse peritoneal exudate
cells (MPEC) was determined. Factors that
increased basal NO synthase activity, interferon
(IFN)-gamma and lipopolysaccharide (LPS),
decreased arginase activity in intact cells.
Transforming growth factor (TGF)-beta1 decreased
IFN-gamma-stimulated NO synthase activity and
produced a reciprocal increase in urea and
ornithine release. TGF-beta1 had no effect on the
activity of these enzymes in LPS-stimulated MPEC.
Corticosterone (Cort, 100 ng/ml) decreased the
basal activity of both enzymes.However, Cort
inhibited NO synthase activity and increased
ornithine release in MPEC exposed to IFN-gamma or
LPS. The difference between arginase activity in
intact cells vs. that of cell lysates suggested
intracellular inhibition of arginase activity.
Products of NO synthase, NO and citrulline, were
shown to inhibit MPEC arginase activity under
maximal assay conditions. Intracellular pH was not
altered by exposure of MPEC to LPS, IFN-gamma,
TGF-beta, and Cort. This reciprocal change in
arginine metabolism is proposed to be an important
component of wound healing. Expression of NO
synthase creates a cytotoxic environment that may
be important to the early phase of wound healing.
As wound healing progresses, increased arginase
activity produces an environment favorable for
fibroblast replication and collagen
production.
The
utilization of nutrient substances during wound
healing
Mayer NA; Muller MJ; Herndon DN
Anesteziol Reanimatol (Russia) Sep-Oct 1996, (5)
p29-39
The process of wound healing represents a
series of complex physicochemical reactions
requiring different nutritional microcomponents at
each stage. In patients with extremely grave
diseases and injuries the course of wound healing
is impaired because of a hypermetabolic reaction
to stress, leading to protein catabolism. The
hypothalamus responds to cytokine stimulation by
changes of thermoregulation (increase of heat
production) and increased production of stress
hormones (catecholamines, hydrocortisone, and
glucagon). In turn, stress hormones trigsis and
proteolysis processes. Hyperproduction of glucose
at the expense of skeletal muscle tissue
degradation leads to the formation of amino acid
substrate for liver glyconeogenesis. Additional
nutrients are obligatory for wound healing in such
patients. Protein catabolism cannot be arrested by
amino acids alone partly because amino acid
transport is impaired; it can be normalized by
anabolics, such as growth hormone and insulin-like
growth factor 1. Treatment with growth hormone
yields a dramatic positive effect in severely
burned children. Proteins and vitamins,
specifically arginine and vitamins A, B, and C
provide the optimal nutritive support during wound
treatment.
A
multicenter clinical trial. Zinc acexamate versus
famotidine in the treatment of acute duodenal
ulcer. Study Group of Zinc acexamate (new UP
doses)
Garcia-Plaza A; Arenas JI; Belda O; Diago A;
Dominguez A; Fernandez C; Martin L; Pallares A;
Rodrigo L; de la Santa Jw
Rev Esp Enferm Dig (Spain) Nov 1996, 88 (11)
p757-62
A multicentric double-blind trial comparing 600
mg/d of Zinc Acexamate (ACZ) and 40 mg/d of
Famotidine (FMT) in the short term treatment of
acute duodenal ulcer included 199 patients,
diagnosed by endoscopy. One-hundred and five
patients received ACZ and 94 FMT, during four
weeks. A clinical control took place at two weeks
and a second clinical and endoscopic control at
the end of the treatment (4 weeks). Complete
cicatrization of the ulcer was observed in 56.5%
of patients on ACZ and in 69.5% of patients of FMT
(N.S.). A reduction of more than 50% of the ulcer
diameter was recorded in 78.8% of the ACZ group
and in 79.9% of the FMT group. Alcohol and smoking
did not influence the results. Both treatments
were equally effective in the disappearance of
symptoms. The incidence of adverse reactions was
very low in both groups (< 5%) and no patient
dropped from the trial for this reason. In
conclusion, a dosage of 600 mg/d of ACZ has
ptors:
Endogenous zinc concentrations in
cysteamine-induced duodenal ulcers in the
rat.
Troskot B; Simicevic VN; Dodig M; Rotkvic I;
Ivankovic D; Duvnjak M
Department of Gastroenterology, University
Hospital Sestre Milosrdnice, Medical School,
University of Zagreb, Croatia.
Biometals (England) Oct 1996, 9 (4) p371-5
Exogenously administered zinc compounds have
been shown to possess anti-ulcer activity against
a wide variety of ulcerogenic agents, both in
laboratory animal models and in human peptic ulcer
disease. However, a strong possibility exists that
endogenous zinc may also play an important role
during noxious events by various mechanisms.
Therefore, the aim of this study was to focus on
the changes of endogenous zinc serum and tissue
concentrations in cysteamine-induced duodenal
lesions. We used atomic absorption
spectrophotometry to determine the tissue and
serum concentrations of zinc in normal (control)
rats and those with cysteamine-induced duodenal
ulcers. The results obtained in this study
indicated that the onset, development and
spontaneous healing of ulcer lesions were
associated with certain shifts in zinc serum and
tissue concentrations. Prior to ulcer formation, a
significant increase was noted in serum zinc
values. With the onset of duodenal lesions, zinc
serum concentrations significantly decreased,
while there was a significant increase in duodenal
tissue concentrations when compared to healthy
control animals. Zinc tissue concentrations
decreased and returned to starting values by the
end of the first week of spontaneous healing. This
decrease in zinc tissue concentration corresponded
to the healing rate of the duodenal ulcers. Serum
zinc concentrations also returned to starting
values within the first week period. These
observations indicate and confirm that zinc could
play an important role in duodenal ulcer disease
and represent a natural defense system in the
body.
Vitamin
supplementation? Experimental study on
humans.
Vaxman F; Olender S; Lambert A; Nisand G;
Grenier JF
INSERM U61 et Laboratoire Pautrier, Chirurgie B,
Hopitaux Universitaires de Strasbourg, France.
Eur Surg Res (Switzerland) Jul-Aug 1996, 28 (4)
p306-14
The improvement of the wound healing process in
humans by vitamin supplements is still
controversial because of the lack of a clearly
demonstrated correlation with the mechanical
properties of scars.
OBJECTIVE: The aim of this work was to study
the effects of high doses of ascorbic acid (AA)
and pantothenic acid (PA) on the wound healing
process of human skin.
METHOD: Two groups of patients undergoing
surgery for tattoo removal by the successive
resection procedure received AA (1 or 3 g/day) and
PA (0.2 or 0.9 g/day). More than 80 mechanical,
biological and histological parameters were
investigated in both preoperated skin and the
scars.
RESULTS: The breaking energy of scars was
higher in group 2, and energy and treatment were
directly correlated (p = 0.006). Mg and Mn
significantly rose in group 2 whereas Fe decreased
in a dose-dependent manner. Intragroup comparison
showed patient and treatment effects for Mg, a
time.treatment effect for Cu and a treatment
effect for Fe.
CONCLUSION: The degree and rapidity of
variations rather than the variations of the
absolute values themselves of fibroblasts,
hydroxyproline, Fe, Cu and Mg are significantly
related to the enhancement of the mechanical
properties of scars. From this study, it may be
assumed that in order to obtain 'better', more
solid and resistant scars, the decrease of Fe must
be quick and acute in order to avoid the harmful
effects of toxic radicals; the increase of Cu, Mg
and Mn must be early and high in order to have
more stable and solid collagen.
Human
dermal fibroblasts produce nitric oxide and
express both constitutive and inducible nitric
oxide synthase isoforms.
Wang R; Ghahary A; Shen YJ; Scott PG; Tredget
EE
Department of Surgery, University of Alberta,
Edmonton, Canada.
J Invest Dermatol (United States) Mar 1996, 106
(3) p419-27
Nitric oxide (NO) is produced by a variety of
human and animal cells and is involved in a broad
rray of physiological and pathophysiological
processes. It can cause vasodilation, serve as a
neurotransmitter, and have anti-neoplastic,
anti-microbial, and anti-proliferative effects. In
this study, we have demonstrated that fibroblasts
derived from human skin spontaneously produce NO
and that this production can be enhanced by
stimulating the cells with interferon-gamma and
lipopolysaccharide. The production of NO by human
dermal fibroblasts can be blocked by
NG-monomethyl-L-arginine (L-NMMA). The inhibitory
effect of L-NMMA on NO production was restored by
addition of L-arginine but not D-arginine. By
measuring the rate of conversion of
[14C]L-arginine to [14C]L-citrulline, we show that
unstimulated cells expressed only Ca2+-dependent
NO synthase (NOS) activity (1.36 +/- 0.57
pmol/mg/min; n = 4) whereas stimulated cells
expressed both Ca2+-dependent (2.60 +/- 0.54
pmol/mg/min; n = 4) and -independent (1.59 +/-
0.14 pmol/mg/min; n = 4) NOS activities. With
reverse transcription polymerase chain reaction
(RT-PCR), the 422-bp RT-PCR product for human
endothelial constitutive NOS and the 462-bp RT-PCR
product for human hepatocyte inducible NOS were
detected in proportion to the amount of
mRNA-related RT-cDNA added to the reaction
mixture. Further evidence by immunocytochemistry
demonstrated that human dermal fibroblasts express
both constitutive and inducible NOS proteins.
These data collectively suggest that in addition
to macrophages and other inflammatory cells,
nitric oxide production by dermal fibroblasts
could be important during the inflammatory stages
of wound healing and possibly also in the later
stages of proliferation and tissue remodeling
after skin injury in humans.
Nutritional factors affecting wound
healing
Thomas DR
Ostomy Wound Manage (United States) Jun 1996, 42
(5) p40-2, 44-6, 48-9
The consistent relationship between poor
nutritional status and risk of complications forms
the cornerstone of nutritional support. Yet there
is controversy about the ability of nutritional
support to reduce complications or improve wound
healing. This controversy stems from a number of
issues. Diagnosing poor nutrition is not always
easy and straight forward. There is sometimes a
question whether a patient is malnourished or
simply in overall poor health. Studies examining
the relationship between nutrition and patient
outcome are typically based on animal rather than
human models. Even in clinical settings, aspects
of care such as enteral or parenteral nutrient
delivery may decrease the benefit of nutritional
support, making outcomes even harder to measure.
The effect of specific nutrients have been
examined, such as protein, amino acids, vitamins C
and A, and zinc. However, there are still
questions regarding how much individual
supplementation of a nutrient will positively
affect overall outcomes. Although the relationship
between specific nutrients and wound healing is
not clearly defined by current studies, each
patient should be provided with a complete,
balanced therapeutic diet. There is at least
suggestive evidence that improvement in
nutritional status can improve outcomes of wound
healing.
Role of
lactose, arginine and lysine combination in
fracture healing (an experimental study)
Fini M; Giardino R; Nicoli Aldini N; Martini L;
Rocca M; Bertoni F; Capelli S; Cantelli Forti G;
Sapone A; Rossetti A; Morrone G; Giavaresi G
Cattedra di Fisiopatologia Chirurgica, Universita
di Bologna.
Ann Ital Chir (Italy) Jan-Feb 1996, 67 (1)
p77-82; discussion 82-3
L-arginine and L-lysine are essential amino
acids which seem to possess some properties able
to influence bone fractures healing. In fact, the
increase of intestinal calcium adsorption but also
in collagen synthesis, in insulin and growth
hormone secretion and in osteoblastic activation.
So, an experimental in vivo model was carried out
by using 50 adult rabbits which, under general
anaesthesia, were submitted to an osteotomy of the
left fibula. Animals were divided into 5 groups
and were daily treated with a mixture of lactose,
L-arginine and L-lysine or with the only lactose
(control group) at the same dosage as recommended
for humans. They were sacrificed after 15, 30, 40,
50 and 60 days for radiological and histological
studies. The results of the study showed that the
pharmacological mixture containing L-arginine and
L-lysine accelerates and ameliorates the healing
processes and this positive effect was
particularly evident from the 30th day after the
osteotomy. We think that these results are linked
not only to calcium metabolism but also to
different biological properties which positively
contribute to good healing of bone fractures.
Activation of a mouse macrophage cell
line by acemannan: The major carbohydrate fraction
from Aloe vera gel
Zhang L.; Tizard I.R.
Dept. of Veterinary Pathobiology, Texas A and M
University, College Station, TX 77843 USA
Immunopharmacology (Netherlands), 1996, 35/2
(119-128)
Acemannan is the name given to the major
carbohydrate fraction obtained from the gel of the
Aloe vera leaf. It has been claimed to have
several important therapeutic properties including
acceleration of wound healing, immune stimulation,
anti-cancer and anti-viral effects. However, the
biological mechanisms of these activities are
unclear. Because of this wide diversity of
effects, it is believed that they may be exerted
through pluripotent effector cells such as
macrophages. The effects of acemannan on the mouse
macrophage cell line, RAW 264.7 cells were
therefore investigated. It was found that
acemannan could stimulate macrophage cytokine
production, nitric oxide release, surface molecule
expression, and cell morphologic changes. The
production of the cytokines IL-6 and TNF-alpha
were dependent on the dose of acemannan provided.
Nitric oxide production, cell morphologic changes
and surface antigen expression were increased in
response to stimulation by a mixture of acemannan
and IFN-gamma. These results suggest that
acemannan may function, at least in part, through
macrophage activation.
Wound
healing effects of aloe gel and other topical
antibacterial agents on rat skin
Heggers J.P.; Kucukcelebi A.; Stabenau C.J.; Ko
F.; Broemeling L.D.; Robson M.C.
Dept Surg Plastic/Microbiol/Immunol., Univ. Texas
Medical Branch/Shriners, Burns Institute,
Galveston, TX 77550 USA
Phytotherapy Research (United Kingdom), 1995, 9/6
(455-457YRE)
The effects of topical antibacterials were
studied in an acute wound healing model. Sprague-
Dawley rats after appropriate anaesthesia received
four 1.5 cm2 dorsal defects through the skin and
panniculus carnosus. Skin defects were treated for
14 days with 2% mupirocin ointment, 1% clindamycin
cream, 1% silver sulfadiazine cream+Aloe vera gel,
and silver sulfadiazine combined with Aloe gel. An
untreated group served as controls. Each group was
comprised of 10 animals each to achieve
statistical significance. Wound closure rate was
assessed by serial planimetry. Following healing,
the breaking strength of each resultant scar was
determined. Wound half-lives and overall healing
rates were calculated by regressing the log of the
areas of all wounds over time. Overall healing
rates of all the treated groups were significantly
different compared with control group (p<0.05)
The Aloe group had the shortest half-life and
healed faster than the control group. All the
other treated groups had no longer half-lives when
compared with the control group. While silver
sulfadiazine+Aloe increased the breaking strength
of the healed wound, Aloe alone did not, but
demonstrated an increase over the control. Topical
Aloe significantly enhances the rate of wound
healing and when combined with silver sulfadiazine
reverses the wound retardant effect observed with
silver sulfadiazine. Clindamycin and mupirocin
significantly delay wound closure. However
mupirocin enhanced the breaking strength of the
wound.
Acemannan-containing wound dressing
gel reduces radiation-induced skin reactions in
C3H mice
Roberts D.B.; Travis E.L.
Texas Univ. M. D. Anderson Can. Ctr., Box 66,
1515 Holcombe Blvd., Houston, TX 77030-4095 USA
International Journal of Radiation Oncology
Biology Physics (USA), 1995, 32/4 (1047-1052)
Purpose: To determine (a) whether a wound
dressing gel that contains acemannan extracted
from aloe leaves affects the severity of
radiation- induced acute skin reactions in C3H
mice; (b) if so, whether other commercially
available gels such as a personal lubricating
jelly and a healing ointment have similar effects;
and (c) when the wound dressing gel should be
applied for maximum effect.
Methods and Materials: Male C3H mice received
graded single doses of gamma radiation ranging
from 30 to 47.5 Gy to the right leg. In most
experiments, the gel was applied daily beginning
immediately after irradiation. To determine timing
of application for best effect, gel was applied
beginning on day -7, 0, or +7 relative to the day
of irradiation (day 0) and continuing for 1, 2, 3,
4, or 5 weeks. The right inner thigh of each mouse
was scored on a scale of 0 to 3.5 for severity of
radiation reaction from the seventh to the 35th
day after irradiation. Dose- response curves were
obtained by plotting the percentage of mice that
reached or exceeded a given peak skin reaction as
a function of dose. Curves were fitted by logit
analysis and ED50 values, and 95% confidence
limits were obtained.
Results: The average peak skin reactions of the
wound dressing gel- treated mice were lower than
those of the untreated mice at all radiation doses
tested. The ED50 values for skin reactions of
2.0-2.75 were approximately 7 Gy higher in the
wound dressing gel-treated mice. The average peak
skin reactions and the ED50 values for mice
treated with personal lubricating jelly or healing
ointment were similar to irradiated control
values. Reduction in the percentage of mice with
skin reactions of 2.5 or more was greatest in the
groups that received wound dressing gel for at
least 2 weeks beginning immediately after
irradiation. There was no effect if gel was
applied only before irradiation or beginning 1
week after irradiation.
Conclusion: Wound dressing gel, but not
personal lubricating jelly or healing ointment,
reduces acute radiation-induced skin reactions in
C3H mice if applied daily for at least 2 weeks
beginning immediately after irradiation.
Anti-inflammatory and wound healing
properties of Aloe vera
Udupa S.L.; Udupa A.L.; Kulkarni D.R.
Department of Biochemistry, Kasturba Medical
College, 576119 Manipal, Karnataka India
Fitoterapia (Italy), 1994, 65/2 (141-145)
The fresh juice of the indigenous drug A. vera
(0.2 ml/100 g, i.p.)was studied for its anti
inflammatory and by observing percent reduction in
carrageenin-induced paw oedema at 3 h. Wound
healing effects were studied on incision (skin
breaking strength), excision (percent wound
contraction and epithelisation time) and dead
space (granuloma breaking strength and biochemical
parameters) wound models. A. vera showed
significant anti-inflammatory activity in acute
inflammatory model without any significant effect
on chronic inflammation. Significant increase in
breaking strength (skin and granuloma tissue),
enhanced wound contraction and decreased
epithelisation period were observed. An increase
in lysyl oxidase activity and mucopolysaccharide
content were also seen. This drug could therefore
increase tensile strength by increasing
cross-linking in collagen and interactions with
the ground substance.
Beneficial effects of Aloe in wound
healing
Heggers J.P.; Pelley R.P.; Robson M.C.
Department of Surgery, University of Texas
Medical Branch, Galveston, TX 77550 USA
Phytother. Res. (United Kingdom), 1993, 7/Spec.
Iss. (S48-S52)
The therapeutic effects of Aloe vera have been
examined in preventing progressive dermal
ischaemia caused by burns, frostbite, electrical
injury,distal dying flap and intra-arterial drug
abuse. In vivo analysis of these injuries showed
that the mediator of progressive tissue damage was
thromboxane A2 (TxA2). Experimentally Aloe was
compared to a variety of antithromboxane agents to
include U38450, a lodoxamide, a lazaroid and
Carrington wound gel. In the burn injury Aloe when
compared with the control and the Carrington wound
gel (p = 0.05). Tissue survival in the
experimental frostbite injury was 28.2% when
compared with the control (p = 0.05). Similar
results were obtained for the electrical injury,
and intra-arterial drug abuse. Clinically burn
patients treated with Aloe healed without tissue
loss as did those with frostbite (p = 0.001). In
the intra-arterial drug abuse patients Aloe
reversed the tissue necrosis. This therapeutic
approach was used to prevent progressive tissue
loss in each injury by actively inhibiting the
localized production of TxA2. Aloe not only acts
as a TxA2 inhibitor but maintains a homeostasis
within the vascular endothelium as well as the
surrounding tissue.
The
stimulation of postdermabrasion wound healing with
stabilized aloe vera gel-polyethylene oxide
dressing
Fulton J.E. Jr.
The Acne Research Institute, 1587 Monrovia
Street, Newport Beach, CA 92663 USA
J. Dermatol. Surg. Oncol. (USA), 1990, 16/5
(460-467)
Full-face dermabrasion provided an ideal
opportunity to document the effects of dressings
on wound healing management. Following the
procedure, the abraded face was divided in half.
One side was treated with the standard
polyethylene oxide gel wound dressings. The other
side was treated with a polyethylene oxide gel
dressing saturated with stabilized aloe vera. The
polyethylene oxide dressing provided an excellent
matrix for the release of aloe vera gel during the
initial 5 days of wound healing. By 24-48 hours
there was dramatic vasoconstriction and
accompanying reduction in edema on the
aloe-treated side. By the third to fourth day
there was less exudate and crusting at the aloe
site, and by the fifth to sixth day the
reepithelialization at the aloe site was complete.
Overall, wound healing was approximately 72 hours
faster at the aloe site. This acceleration in
wound healing is important to reduce bacterial
contamination, subsequent keloid formation, and/or
pigmentary changes. The exact mechanism of
acceleration of wound healing by aloe vera is
unknown.
Aloe
vera gel hindered wound healing of experimental
second-degree burns: A quantitative controlled
study
Kaufman T.; Kalderon N.; Ullmann Y.; Berger
J.
Department of Plastic Surgery, Bruce G. MacMillan
Burn Wound Healing Research Unit, Haifa Israel
J. Burn Care Rehabil. (USA), 1988, 9/2
(156-159)
In the present study, Aloe vera gel (AVG) was
applied to experimental second-degree burns in
guinea pigs, and its effects on epithelialization,
wound contraction, newly formed granulation
tissue, and regeneration of hair follicles was
compared with that effected by 1% silver
sulfadiazine cream (AgSD). Epithelialization (%
mean plus or minus SEM) on postburn day 8, 16, and
24 of the AVG-treated wounds was 38.72% plus or
minus 2.71%, 60.34% plus or minus 3.28%, and
92.46% plus or minus 2.26%, respectively, while
that of AgSD-treated burns was 53.35% plus or
minus 2.65%, 94.84% plus or minus2.65%wounds was
significantly higher than that of the AgSD-tr
eated burns during 24 days of the study (P <
.001). The thickness of the newly formed
granulation tissue was higher in the AVG-treated
wounds (P < .001), while the hair follicles
count was significantly lower (P < .001)
compared with the AgSD-treated burns. It is
concluded that this preparation of Aloe vera gel
hindered the healing process of the present burn
wound model when compared with 1% silver
sulfadiazine cream.
Biological activity of Aloe
vera
Davis R.H.; Leitner M.G.; Russo J.M.; Maro
N.P.
Pennsylvania College of Podiatric Medicine,
Department of Physiological Sciences,
Philadelphia, PA 19107 USA
Med. Sci. Res. (UK), 1987, 15/5 (235)
In this study, the authors attempted to show
the comparative biological activity of Aloe vera
as measured by standard anti-inflammatory tests.
Wound healing was improved 24% in mice by a 100
mg/kg Aloe vera dose whereas 10 mg/kg improved
healing 31% in rats. A slightly greater response
of 44% was obtained on inhibiting mustard induced
edema by 10 mg/kg Aloe vera. A marked inhibition
of 58% PMN infiltration into an inflamed area by 2
mg/kg aloe was noted. No reduction of granuloma
tissue formation around a cotton pellet under the
skin was shown at doses up to 400 mg/kg. These
data suggest that Aloe vera inhibits inflammation
and improves wound healing. Aloe vera probably
does not act like a steroid since it was most
effective on acute inflammation and had no effect
on granuloma tissue formation.
Cutaneous tissue repair: Practical
implications of current knowledge. II
Reed B.R.; Clark R.A.F.
Department of Dermatology, University of Colorado
Health Sciences Center, Denver, CO 80262 USA
J. Am. Acad. Dermatol. (USA), 1985, 13/6
(919-941)
This article reviews the scientific basis for
the certain factors that delay wound repair in the
clinical setting. A brief history of wound healing
is given, followed by a discussion of endogenous
local factors (bacterial infection, hypoxia,
foreign body, and desiccation) and endogenous
systemic factors (nutritional deficiencies, aging,
coagulation disorders, and the Ehlers-Danlos
syndromes) associated with poor wound repair. Also
reviewed are the mechanisms by which exogenously
administered agents (glucocorticoids,
antineoplastic agents, and anticoagulants) may
delay healing. Commonly used topical
antimicrobials, their spectrum of activity, and
evidence of effects on wound healing are examined.
Finally, properties of commercially available
wound coverings and wound care in the future are
discussed.
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