Wound fluid intervention: influencing wound healing from the outside | Wound Healing Southern Africa
Wound fluid intervention: influencing wound healing from the outside
Keywords: chronic wound fluid, exudate, MMP, biofilm	
Wound fluid constituents are often used as a means to mirror events occurring at a molecular level within the wound. This is especially so in chronic wounds, where excess destruction of the extracellular matrix is brought about by exuberant activity of potent clearing agents, predominantly in the form of matrix metalloproteinases (MMPs). These MMPs are found to exist in significant amounts in the chronic wound fluid. It has become apparent that these enzymes not only reflect the destructive milieu within the wound, but may in fact contribute to this destruction by nature of their corrosive effects on the wound bed and peri-wound skin. A new approach to influencing wound healing may logically involve neutralising these corrosive enzymes within the wound fluid, and initiating a more balanced MMP:growth factor ratio. It is expected that this would trigger healing. This paper examines the logic of this approach, and suggests possible ways in which current dressings may already be influencing wound healing due their effect on chronic wound fluid.
MBBCh, FCS(SA Plast), MMed(Wits), FACS Honorary Professor Department of Plastic Surgery University of the Witwatersrand and Irvine California USA