Wounds UK | Vol 9 | No 1 | 2013 Research and Audit Impact of medications and lifestyle factors on wound healing: A pilot study W ound healing is a complex phenomenon conducted by various types of tissues, cell lineages, and hormones, all functioning in collaboration (Martin, 1997). Chronic wounds fail to progress through the wound healing cycle, and typically become suspended in one phase. Numerous aetiological factors have been identiied as promoting chronicity in wounds, including venous and arterial insuiciency, diabetes, and autoimmune diseases (Schreml et al, 2010). Other factors that can negatively afect wound healing include some pharmacotherapies, surgical intervention, infection, trauma, psychological stress, and smoking (Silverstein, 1992; Kiecolt-Glaser et al, 1995; Karukonda et al, 2000a; Edwards and Harding, 2004). Patients with chronic wounds typically have several comorbidities (Stadelmann, 1997) and polypharmacy is also common (Sussman, 2007). Medications can either assist or inhibit speciic phases of wound healing (Karukonda et al, 2000b; Sussman, 2007). Some examples of drugs, with a summary of their individual impact on wound healing, are provided in Appendix 1. Despite known detrimental effects on wound healing, the majority of these medications are clinically important, and cessation is not always feasible when a patient develops a wound. For example, Warfarin is essential in reducing thromboembolism in patients with a metallic heart valve, yet impacts negatively on wound healing (Douketis et al, 2008). Aspirin is another example of a potentially essential medication that hinders wound healing (Raghavan et al, 2006). Lifestyle factors can also impact wound healing. For example, alcohol consumption can impede wound healing and increase the incidence of infection. Regardless of the level of alcohol consumption (i.e. acute or chronic), it has been demonstrated to disturb re-epitheliasation, angiogenesis, collagen production, wound closure, and increases susceptibility to infection (Guo and Dipietro, 2010). AIM In the present study, the authors sought to evaluate clinically relevant pharmacological agents and 22 CHARLOTTE WIGSTON Fourth-year medical student, School of Medicine, Cardif University SHOAIB HASSAN Fourth-year medical student, School of Medicine, Cardif University SUZANNE TURVEY Fourth-year medical student, School of Medicine, Cardif University DAVID BOSANQUET Clinical Research Fellow, Institute for Translation, Innovation, Methodologies and Engagement, School of Medicine, Cardif University ALASTAIR RICHARDS Clinical Research Fellow, Institute for Translation, Innovation, Methodologies and Engagement, School of Medicine, Cardif University SAMANTHA HOLLOWAY Clinical Research Fellow, Institute for Translation, Innovation, Methodologies and Engagement, School of Medicine, Cardif University KEITH HARDING Director, Institute for Translation, Innovation, Methodologies and Engagement, School of Medicine, Cardif University Background: Wound chronicity can be due to a range of intrinsic and extrinsic factors, some of which can be controlled. Aim: The main aim of this pilot study was to explore how medications, smoking, and alcohol affect healing rates in a sample of patients at three tertiary wound care clinics. Methods: Seventy-three patients, each with an open wound, were included in the study. Medical history, concomitant medications, smoking status, and alcohol consumption were recorded. Patients’ wounds were classified as healing or nonhealing based on the comparisons of wound size change since previous visits. Logistic regression with groups of medications known to affect wound healing was undertaken to investigate their ability to independently predict outcome. Results: Groups were well matched for comorbidities, and amount of concomitant medications taken. Logistical regression identified antibiotics as being associated with healing, although this did not reach statistical significance (P=0.07). Alcohol consumption over the recommended allowance was associated with nonhealing (P=0.043). Conclusion: The results suggest that excess alcohol consumption may delay wound healing. A larger study is needed to further the questions. KEY WORDS Chronic wound Drug therapy Lifestyle factor Wound healing