Growth Factors and Wound Healing
Souba Willey W,MD ScD –
Role of Growth Factors :
(1) Attracting macrophages to wound environment.
(2) Regulating synthesis of collagen and connective tissue.
(4) Tissue Remodelling.
Explosion in biotechnology capabilities has allowed for the first time, the production of growth factors in large quantities. These compounds can be synthesized in megadoses by genetically engineered “smart bacteria”.
LN Jorgensen, F Kallehave, E Christensen et al , 1998. (Univ of Copenhagen) :
Less Collagen Production in Smokers.
Surgery 123: 450-455
Smokers showed a specific impairment of subcutaneous collagen synthesis – consistent with reports of impaired wound healing in smokers.
Patients should therefore be advised to quit smoking before undergoing surgery and even for ever after !!
J Lazarou, BH Pomeranz, PN Corey, 1998. (Univ of Toronto) :
Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies. JAMA 279: 1200-1205
There was a 6.7% overall incidence of serious adverse reactions, with a 0.32% incidence of fatal adverse reactions in hospitalized patients. Serious adverse reactions in the USA estimated to number 2,216,000 in 1994 with fatal adverse reactions estimated to number 106,000 making adverse reactions between the 4th and 6th leading cause of death, ranking below heart disease, cancer, stroke, pulmonary disease and accidents and above pneumonia and diabetes.
MB Witte, FJ Thornton, T Kiyama et al 1998 (Johns Hopkins Med Institutions, Baltimore, Md; Univ of Florida, Gainesville): Metalloproteinase inhibitors and wound healing: A Novel Enhancer of Wound Strength.
Surgery 124 : 464-470.
Without an increase in collagen deposition .
GM6001 – Novel inhibitor of metalloproteinase (MMPs) - its use decreased inflammatory infiltrate, the collagen content, and the collagen type I gene expression in the sponge granulomas.
M-L Ivarsson, M Bergstrom, E Eriksson et al , 1998. (Goteborg Univ, Sweden),
Tissue Markers As Predictors of Postoperative Adhesions.
Br J Surg 85: 1549-1554
Post-operative adhesions are associated with a decreased capacity to degrade intra-abdominally deposited fibrin, largely because of an increased expression of PAI-1 (Plasminogen activator inhibitor type1).
KE Rodgers, W Girgis, K St.Amand et al
Reduction of Adhesion Formation in Rabbits by Intraperitoneal Administration of Lazaroid Formulations
Hum Reprod 13 : 2443-2451
Lazaroids exert their mechanism of action by inhibiting lipid peroxidation reactions as well as the production of reactive tissue metabolites. Lazaroids could act to block the inhibition of fibrinolysis.