Inflammation in Chronic Wounds

Abstract

Non-healing chronic wounds present a major biological, psychological, social, and financial burden on both individual patients and the broader health system. Pathologically extensive inflammation plays a major role in the disruption of the normal healing cascade. The causes of chronic wounds (venous, arterial, pressure, and diabetic ulcers) can be examined through a juxtaposition of normal healing and the rogue inflammatory response created by the common components within chronic wounds (ageing, hypoxia, ischaemia-reperfusion injury, and bacterial colonisation). Wound bed care through debridement, dressings, and antibiotics currently form the basic mode of treatment. Despite recent setbacks, pharmaceutical adjuncts form an interesting area of research.

Keywords: ageing; arterial ulcer; bacterial colonisation; chronic wound; diabetic ulcer; hypoxia; inflammation; ischaemia-reperfusion; pressure ulcer; venous ulcer.

Figure 1

The role of inflammation in the pathophysiology of common chronic wounds. ROS = reactive oxygen species, ECM = extracellular matrix.