The Role of Calcium in Wound Healing

Abstract

Skin injury is quite common, and the wound healing is a complex process involving many types of cells, the extracellular matrix, and soluble mediators. Cell differentiation, migration, and proliferation are essential in restoring the integrity of the injured tissue. Despite the advances in science and technology, we have yet to find the ideal dressing that can support the healing of cutaneous wounds effectively, particularly for difficult-to-heal chronic wounds such as diabetic foot ulcers, bed sores, and venous ulcers. Hence, there is a need to identify and incorporate new ideas and methods to design a more effective dressing that not only can expedite wound healing but also can reduce scarring. Calcium has been identified to influence the wound healing process. This review explores the functions and roles of calcium in skin regeneration and reconstruction during would healing. Furthermore, this review also investigates the possibility of incorporating calcium into scaffolds and examines how it modulates cutaneous wound healing. In summary, the preliminary findings are promising. However, some challenges remain to be addressed before calcium can be used for cutaneous wound healing in clinical settings.

Keywords: calcium; fibroblast; keratinocyte; skin; wound healing.

Figure 1

Illustration of the wound-healing process. Wound healing is divided into four phases: (a) hemostasis, (b) inflammation, (c) proliferation, and (d) remodeling. Hemostasis involves the formation of fibrin clot to stop the bleeding. Inflammation phase is associated with the infiltration of leukocytes to remove the cellular debris and infectious agents. During the proliferation phase, keratinocytes, fibroblasts, and endothelial cells undergo proliferation and migration to re-epithelialize, lay down collagen matrix, and revascularize the wound, respectively. Finally, the wound become mature during the remodeling phase.