Popli and Badhwar DOI:
Submitted to:
International Journal of Drug Delivery
REVIEW ARTICLE
Current Aspects and Therapies for Wound
healing
Harvinder Popli and Reena Badhwar
*
Abstract
Injury to the skin provides a new challenge, as wound healing is a complex and intricate process. Nonhealing wounds represent a
significant cause of morbidity and mortality for a large portion of the population. Delayed wound healing is one of the major ther-
apeutic and economic issues in medicine today. Wound healing requires a concerted effort of remodeling of various components
of the connective tissue in the presence of appropriate cytokines and growth factors. Unfortunately we still do not understand the
actual mechanism of wound healing. This review is an effort to provide information about current challenges of wound healing and
their management, recent advances in wound care technology and current management guidelines for the treatment of wounds
and ulcers. Various steps like microbial control, subsidence of inflammation, regeneration of connective tissue, angiogenesis and
epithelialisation should take place in a time-bound sequence. The development of new and effective interventions in Wound care
remains an area of intense research
Keywords: Non healing wounds and ulcer; current challenges; mechanism; cytokines; growth factors
Introduction
Wound healing is a highly dynamic process and involves com-
plex interactions of extracellular matrix molecules, soluble me-
diators, various resident cells, and infiltrating leukocyte sub-
types [1]. Wound-healing process consists of four highly inte-
grated and overlapping phases: homeostasis, inflammation, cell
proliferation, and lesion contraction or tissue remodeling [2].
There are many factors that can affect wound healing. Wound
healing a matter of concern even with advance therapies [3].
There are many factors that can affect wound healing which in-
terfere with one or more phases in this process, thus causing
improper or impaired tissue repair [4]. Currently, there are var-
ious challenges in wound healing such as antibiotics resistance,
different wound healing rate and wound healing abilities of pa-
tients.
*
Correspondence: reenabadhwar000@gmail.com
Delhi Pharmaceutical Sciences, Department of Pharmaceutics,
Research University, New Delhi, India
Full list of author information is available at the end of the article.
Epidemiology of wound healing
According to the Wound Healing Society, about 15% of older
adults in the US suffer from chronic wounds, including pre-
dominantly venous stasis ulcers, pressure ulcers (bedsores), and
diabetic (neuropathic) foot ulcers. Every year 2 to 3 million
more Americans are diagnosed with various types of chronic
wounds [5, 6]. Most of the ulcers in India are undoubtedly due to
venous etiology, but many other causes such as filariasis, tuber-
culosis, and leprosy, not frequently seen in the western countries,
add to the misery of the Indian patient. The study from India
shows that etiology of chronic wounds included systemic con-
ditions such as diabetes and atherosclerosis. Other major causes
included pressure ulcers, vasculitis, and trauma [7]. There are
few Indian studies on the epidemiology of chronic wounds, one
study estimated the prevalence at 4.5/1000 population while, the
incidence of acute wounds was more than double at 10.5/1000
population [8, 9].
Categories of wounds
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