The chronic wound: impaired healing and solutions in the context of wound bed preparation
The chronic wound: impaired healing and solutions in the context of wound bed preparation
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DOI：
10.1016/j.bcmd.2003.09.020
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发表时间：
2004-01-01
影响因子：
2.3
通讯作者：
Falanga, V
中科院分区：
文献类型：
--
作者：
Falanga, V
在过去的几年中，出现了一种不同的理解和治疗慢性伤口的范式。用来描述这种新情况的术语是“伤口床准备”。这个术语正在彻底改变我们治疗慢性伤口的方式，并使慢性伤口从既定的急性损伤模型中获得独立。在伤口床准备的背景下，受损的愈合和解决方案正在以新的方式解决。本文以糖尿病性溃疡为例，重点介绍了糖尿病性溃疡的病理生理学原理、细胞和分子的异常，以及基因治疗和干细胞治疗的新方法。新出现的观点是，慢性伤口的特征是驻留细胞经历了表型变化，需要纠正以实现最佳愈合。我们已经在动物模型和人类身上证实，干细胞有可能在修复过程中带来根本性的变化，并最终在我们的治疗成功中实现“量子”飞跃。(C) 2003 Elsevier Inc.版权所有。
In the past few years, a different paradigm for the understanding and treatment of chronic wounds has emerged. The term used to describe this new context in which failure to heal is viewed is "wound bed preparation". This term is revolutionizing the way we approach chronic wounds, and has allowed chronic wounds to gain independence from established models of acute injury. Within the context of wound bed preparation, impaired healing and solutions to it are being addressed in novel ways. In this report, we make use of the diabetic ulcer as an example of a chronic wound, and emphasize the pathophysiological principles, the cellular and molecular abnormalities, and the solutions offered by the new approaches of gene therapy and stem cells. The emerging view is that chronic wounds are characterized by resident cells that have undergone phenotypic changes that need to be corrected for optimal healing to occur. We have established in animal models and in humans that stem cells have the potential to bring about fundamental changes in the repair process and, ultimately, a "quantum" jump in our therapeutic success. (C) 2003 Elsevier Inc. All rights reserved.