The theory of the "three healing gestures" was formed more than 4000 years ago,
These three gestures have survived over time, evolving into varying forms of today's same basic themes:
- Cleansing the wound to remove callus and debris; this may include debridement
- Applying dressings to prevent infection
- Bandaging the wound, or removing pressure from the wound to prevent reinjury
How do Wounds Heal?
Wound healing involves three phases:
- Inflammation -- the point when blood clots form, bacteria are attacked, and there is an orderly recruitment of key cells into the wound site
- Proliferation -- when cells necessary for wound closure proliferate at the wound site to make new tissue and capillaries (part of "granulation" tissue).
- Remodeling -- when the wound is healed and the initial scar tissue is restructured
The Greek tradition of dry healing came from Hippocrates, who felt that a dry environment was closer to the condition of normal tissue2. At this time, the only function of dressings was to protect the wound from reinjury.
It was not until the 1960s that the concept of a moist wound healing environment was considered2. In addition to protecting the wound from infection, the moist environment would help to facilitate natural debridement, minimize inflammation, reduce pain, and diminish scarring.
Today there are more than 2000 wound care products available, most of which are different varieties of dressings2. Most modern dressings contain materials that are highly absorbent, such as alginates or foam. The list of modern wound dressings available is long and impressive; some types include1:
- Alginates
- Composites
- Exudate absorbers
- Foams
- Gauzes
- Hydrocolloids
- Hydrogels
- Skin Sealants
- Transparent Films
The Role of Growth Factors in Wound Healing
- the future
What are Growth Factors?
Many cell types are involved in wound healing, including platelets, macrophages and fibroblasts. Platelets are the first cell components to invade the wound site and initiate the wound healing process by releasing growth factors.
Growth factors are classified as cytokines, which are proteins that act as intercellular signals to allow cells to communicate with one another. Growth factors are actually a subclass of cytokines that specifically stimulate the migration and proliferation of cells and synthesis of new tissues.
How Do They Work?
Growth factors are involved in all three phases of wound healing and also have the ability to regulate many other functions within the cell, including protein synthesis. Growth factors are essential to wound healing.
Specifically, they:
- Attract useful cells and proteins to the wound, including immune cells to fight infection and other cells to form connective tissue
- Stimulate and increase production of connective tissue
- Create a new supply of blood vessels to nourish the site
- Promote remodeling
What is Platelet-Derived Growth Factor?
Platelet-derived growth factor is one of the earliest of several growth factors identified in the wound healing process. The growth factor is a product of platelets and other cell types as well, including macrophages and endothelial cells.
The function of platelet-derived growth factor is most evident at the proliferation stage in open wounds where granulation begins. Upon release at the wound site, it stimulates migration and proliferation of cells important to the wound healing process so that the wound fills with healthy tissue.
References:
- Mulder GD, Haberer PA, Jeter KF, eds. Clinicians' Pocket Guide to Chronic Wound Repair. 4th ed. Springhouse, PA: Springhouse Corporation; 1998:85.
- Cohen IK. A Brief History of Wound Healing. 1st ed. Yardley, PA: Oxford Clinical Communications Inc; 1998.
