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The "Grow" in Integrow

Rather than medical advice, this page provides valuable information about the wound healing processes. Discover the essential information about wound healing, so you may make educated decisions about your purchases. Explore the science behind wound care and take the first step towards better healing today! 

General Overview

Healing is Homeostasis

Homeostasis, or the equilibrium of physiological elements, is disturbed when you are injured. In other words, your body is thrown off balance and it tries to re-establish that equilibrium through healing. 

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The ideal wound healing environment is one that is clean and moist. Clean means that there is a low bacterial population, and moist means that it is not dried out, but also not too wet where it is at the point of leaking. If a wound is scabbing over or crusting, then it is far too dry and will take a significantly longer time to heal as cells will not be able to migrate towards each other and close the wound. 

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The different stages of wound healing and their respective cascades including physiological actions and actors. (Fernandez-Guarino et al.)

Figure 2: Healing cascade (Fernandez-Guarino et al.)

Difference in phases of normal (acute) and abnormal (chronic) wound healing (Gounden et al.)
Difference in phases of normal (acute) and abnormal (chronic) wound healing (Gounden et al.)

Figure 1. Difference in phases of normal (acute) and abnormal (chronic) wound healing (Gounden, Varshan, and Moganavelli Singh)

Inflammation is the same, where too much inflammation leads to a slow healing process or a chronic non-healing wound, but without the inflammatory process you would never heal. This is because the "inflammatory cascade" is the sequence of events that the body goes through to heal.

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It is your job to keep your wound clean and moisturized! The best way to clean a wound is the tried and true method of using soap and water! One can use antiseptic solutions during dressing changes, but using soap and water in the shower is easy and extremely effective. Specifically, the suds from the soap are important as the foam and bubbles help to better surround and wash away dirt and bacteria. 

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Once it is clean, a wound should be dressed with either a moist or dry dressing depending on the wound. We offer multiple effective options for dry and wet wounds at our store. Visit our store for a variety of wound care materials for cleaning and dressing wounds. We provide excellent dressings that are affordable and in use at top of the line wound care facilities! 

Ideal system for wound healing (Gounden, Varshan, and Moganavelli Singh).

Figure 3. Ideal system for wound healing (Gounden, Varshan, and Moganavelli Singh)

More in Depth...

     It is apparent in the literature and daily practice of wound care that wounds are able to heal faster based on different treatment methods. Excision of necrotic tissue and proper nutrition through diet have shown to increase rates of wound closure. These are two different methods of supporting the wound environment, but help to promote and accelerate healing. Another method is administration of various topicals that aid in the cleaning, debridement, or hydration of a wound. If there is a compromised blood supply to the area, this method becomes more important than oral nutrition. As the nutrients are not able to reach the wound through the bloodstream, the topical route becomes the main method of alleviating the stressors on the injured site. For example, large total body surface area (TBSA) patients are not able to circulate antibiotics (oral or IV route) to a wound bed due to the lack of blood supply resulting from the damaged capillary network. This leads to the need of proper cleaning and topical antimicrobial agents to dilute surface bacterial populations and inhibit further growth. However, once the damaged blood supply regrows and gains function, the wound will start to receive blood and in turn, oxygen and nutrients. 

 

     There are 4 stages of wound healing; 1) hemostasis 2) inflammation 3) proliferation and 4) remodeling, and this process of tissue and vessel growth is present in all wounds and is a result of the inflammatory cascade taking place after the onset of injury. Stage 2 is generally where we begin when speaking about wound care, unless there is a trauma where profuse and excessive bleeding occurs. In the inflammatory second stage, alongside the reagents that promote healing, there are the oxidative and negative influences of inflammation. These slow the growth of tissue as their cytotoxic qualities combat the positive action of the tissue growth factors. 

 

     If the cells make it to a living state and into the proliferative stage, they will need to a) migrate and b) stay alive. This calls for a hydrated environment with a low bacterial population. This can be maintained by cleaning, either with soap and water or antiseptic solutions, and by the use of topicals with antimicrobial agents. The common form of this topical is the household antibiotic ointment. Neosporin is the common, household triple antibiotic, but constant use over a long period of time has shown irritation in a large portion of the population. For this reason, clinicians will turn to a double or single antibiotic option or use non-anti-biotic containing products that are effective in decreasing bacterial growth. An example of this is silver sulfadiazine or Silvadene (SSD).

 

     The fourth stage is where remodeling occurs and this process lasts the longest. It is where scar formation and maturation occur and could last for years. There are surgical and topical treatments for this stage as well, including tissue excision or manipulation, injections, lasers, and scar gels and tapes. The efficacy for some treatments may be comparable, but the rate of improvement of these alternatives vary. While surgical intervention is the most effective and quickest route, it is far more costly and painful. Topical administration of scar gels or bleaching creams may take months to achieve texture and color goals or may not satisfy one's expectations, but they are considerably more affordable. 

References

  1. Abbas, ManalMohammad, Naseer Al-Rawi, ManalAhmad Abbas, and Iqbal Al-Khateeb. “Naringenin Potentiated β-Sitosterol Healing Effect on the Scratch Wound Assay.” Research in Pharmaceutical Sciences 14, no. 6 (2019): 566. https://doi.org/10.4103/1735-5362.272565.

  2. Arslan, Kemal, Omer Karahan, Ahmet Okus, Yasar Unlu, Mehmet Ali Eryilmaz, Serden Ay, and Baris Sevinc. “Comparison of Topical Zinc Oxide and Silver Sulfadiazine in Burn Wounds: An Experimental Study.” Turkish Journal of Trauma and Emergency Surgery 18, no. 5 (2012): 376–83. https://doi.org/10.5505/tjtes.2012.45381.

  3. Ashkani Esfahani, Soheil, Mahsima Khoshneviszadeh, Mohammad Reza Namazi, Ali Noorafshan, Bita Geramizadeh, Elham Nadimi, and Seyedeh Tahereh Razavipour. “Topical Nicotinamide Improves Tissue Regeneration in Excisional Full-Thickness Skin Wounds: A Stereological and Pathological Study.” Trauma Monthly 20, no. 4 (November 23, 2015). https://doi.org/10.5812/traumamon.18193.

  4. Babayevska, Nataliya, Łucja Przysiecka, Igor Iatsunskyi, Grzegorz Nowaczyk, Marcin Jarek, Ewa Janiszewska, and Stefan Jurga. “ZnO Size and Shape Effect on Antibacterial Activity and Cytotoxicity Profile.” Scientific Reports 12, no. 1 (May 17, 2022): 8148. https://doi.org/10.1038/s41598-022-12134-3.

  5. Balachandran, Abbirami, Sy Bing Choi, Morak-Młodawska Beata, Jeleń Małgorzata, Gabriele R. A. Froemming, Charlie A. Lavilla, Merell P. Billacura, Stepfanie N. Siyumbwa, and Patrick N. Okechukwu. “Antioxidant, Wound Healing Potential and In Silico Assessment of Naringin, Eicosane and Octacosane.” Molecules 28, no. 3 (January 20, 2023): 1043. https://doi.org/10.3390/molecules28031043.

  6. Chen, Li-Ru, Bing-Shiang Yang, Chih-Ning Chang, Chia-Meng Yu, and Kuo-Hu Chen. “Additional Vitamin and Mineral Support for Patients with Severe Burns: A Nationwide Experience from a Catastrophic Color-Dust Explosion Event in Taiwan.” Nutrients 10, no. 11 (November 16, 2018): 1782. https://doi.org/10.3390/nu10111782.

  7. Chen, Rui, Qiao-Ling Qi, Meng-Ting Wang, and Qi-Yan Li. “Therapeutic Potential of Naringin: An Overview.” Pharmaceutical Biology 54, no. 12 (December 1, 2016): 3203–10. https://doi.org/10.1080/13880209.2016.1216131.

  8. Collins, Tracy M., Richard Caimi, Peter R. Lynch, Joel Sheffield, Amit Mitra, Kristin Stueber, and Yale R. Smith. “The Effects of Nicotinamide and Hyperbaric Oxygen on Skin Flap Survival.” Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 25, no. 1 (January 1991): 5–7. https://doi.org/10.3109/02844319109034915.

  9. El-Fallal, Amira A., Reham A. Elfayoumy, and Mohamed M. El-Zahed. “Antibacterial Activity of Biosynthesized Zinc Oxide Nanoparticles Using Kombucha Extract.” SN Applied Sciences 5, no. 12 (December 2023): 332. https://doi.org/10.1007/s42452-023-05546-x.

  10. Fernández-Guarino, Montserrat, Stefano Bacci, Luis Alfonso Pérez González, Mariano Bermejo-Martínez, Almudena Cecilia-Matilla, and Maria Luisa Hernández-Bule. “The Role of Physical Therapies in Wound Healing and Assisted Scarring.” International Journal of Molecular Sciences 24, no. 8 (April 19, 2023): 7487. https://doi.org/10.3390/ijms24087487.

  11. Galiano, Robert D., Oren M. Tepper, Catherine R. Pelo, Kirit A. Bhatt, Matthew Callaghan, Nicholas Bastidas, Stuart Bunting, Hope G. Steinmetz, and Geoffrey C. Gurtner. “Topical Vascular Endothelial Growth Factor Accelerates Diabetic Wound Healing through Increased Angiogenesis and by Mobilizing and Recruiting Bone Marrow-Derived Cells.” The American Journal of Pathology 164, no. 6 (June 2004): 1935–47. https://doi.org/10.1016/S0002-9440(10)63754-6.

  12. Gorski, Julian, Ehrhardt Proksch, Jens Malte Baron, Daphne Schmid, and Lei Zhang. “Dexpanthenol in Wound Healing after Medical and Cosmetic Interventions (Postprocedure Wound Healing).” Pharmaceuticals 13, no. 7 (June 29, 2020): 138. https://doi.org/10.3390/ph13070138.

  13. Gounden, Varshan, and Moganavelli Singh. “Hydrogels and Wound Healing: Current and Future Prospects.” Gels 10, no. 1 (January 5, 2024): 43. https://doi.org/10.3390/gels10010043.

  14. Heise, Ruth, Laurenz Schmitt, Laura Huth, Laura Krings, David Kluwig, Krista-Vasiliki Katsoulari, Timm Steiner, Frank Hölzle, Jens Malte Baron, and Sebastian Huth. “Accelerated Wound Healing with a Dexpanthenol-Containing Ointment after Fractional Ablative CO 2 Laser Resurfacing of Photo-Damaged Skin in a Randomized Prospective Clinical Trial.” Cutaneous and Ocular Toxicology 38, no. 3 (July 3, 2019): 274–78. https://doi.org/10.1080/15569527.2019.1597879.

  15. Kandhare, Amit D., Javed Alam, Mithun V. K. Patil, Akanksha Sinha, and Subhash L. Bodhankar. “Wound Healing Potential of Naringin Ointment Formulation via Regulating the Expression of Inflammatory, Apoptotic and Growth Mediators in Experimental Rats.” Pharmaceutical Biology 54, no. 3 (March 3, 2016): 419–32. https://doi.org/10.3109/13880209.2015.1038755.

  16. Kobayashi, Daisaku, Miho Kusama, Masaaki Onda, and Norimichi Nakahata. “The Effect of Pantothenic Acid Deficiency on Keratinocyte Proliferation and the Synthesis of Keratinocyte Growth Factor and Collagen in Fibroblasts.” Journal of Pharmacological Sciences 115, no. 2 (2011): 230–34. https://doi.org/10.1254/jphs.10224SC.

  17. Larson, Nicholas R., Yangjie Wei, Indira Prajapati, Aishik Chakraborty, Bjorn Peters, Cavan Kalonia, Suzanne Hudak, et al. “Comparison of Polysorbate 80 Hydrolysis and Oxidation on the Aggregation of a Monoclonal Antibody.” Journal of Pharmaceutical Sciences 109, no. 1 (January 2020): 633–39. https://doi.org/10.1016/j.xphs.2019.10.069.

  18. Lin, Pei-Hui, Matthew Sermersheim, Haichang Li, Peter H. U. Lee, Steven M. Steinberg, and Jianjie Ma. “Zinc in Wound Healing Modulation.” Nutrients 10, no. 1 (December 24, 2017): 16. https://doi.org/10.3390/nu10010016.

  19. Mendes, Carolina Rosai, Guilherme Dilarri, Carolina Froes Forsan, Vinícius De Moraes Ruy Sapata, Paulo Renato Matos Lopes, Peterson Bueno De Moraes, Renato Nallin Montagnolli, Henrique Ferreira, and Ederio Dino Bidoia. “Antibacterial Action and Target Mechanisms of Zinc Oxide Nanoparticles against Bacterial Pathogens.” Scientific Reports 12, no. 1 (February 16, 2022): 2658. https://doi.org/10.1038/s41598-022-06657-y.

  20. Moreno-Eutimio, Mario Adan, Lorena Espinosa-Monroy, Tania Orozco-Amaro, Yessica Torres-Ramos, Araceli Montoya-Estrada, Juan Jose Hicks, Ernesto Rodríguez-Ayala, Pamela Del Moral, Jose Moreno, and Jorge Cueto-García. “Enhanced Healing and Anti-Inflammatory Effects of a Carbohydrate Polymer with Zinc Oxide in Patients with Chronic Venous Leg Ulcers: Preliminary Results.” Archives of Medical Science, 2016. https://doi.org/10.5114/aoms.2016.59851.

  21. Rembe, Julian-Dario, Carolin Fromm-Dornieden, and Ewa Klara Stuermer. “Effects of Vitamin B Complex and Vitamin C on Human Skin Cells: Is the Perceived Effect Measurable?” Advances in Skin & Wound Care 31, no. 5 (May 2018): 225–33. https://doi.org/10.1097/01.ASW.0000531351.85866.d9.

  22. Saghiri, Mohammad Ali, Armen Asatourian, Soroush Ershadifar, Mona Momeni Moghadam, and Nader Sheibani. “Vitamins and Regulation of Angiogenesis: [A, B1, B2, B3, B6, B9, B12, C, D, E, K].” Journal of Functional Foods 38 (November 2017): 180–96. https://doi.org/10.1016/j.jff.2017.09.005.

  23. Sun, Rui, Chunyan Liu, Jian Liu, Siyuan Yin, Ru Song, Jiaxu Ma, Guoqi Cao, et al. “Integrated Network Pharmacology and Experimental Validation to Explore the Mechanisms Underlying Naringenin Treatment of Chronic Wounds.” Scientific Reports 13, no. 1 (January 4, 2023): 132. https://doi.org/10.1038/s41598-022-26043-y.

  24. Ueda, Yutaka, Kota Mashima, Motoyasu Miyazaki, Shuuji Hara, Tohru Takata, Hidetoshi Kamimura, Satoshi Takagi, and Shiro Jimi. “Inhibitory Effects of Polysorbate 80 on MRSA Biofilm Formed on Different Substrates Including Dermal Tissue.” Scientific Reports 9, no. 1 (February 28, 2019): 3128. https://doi.org/10.1038/s41598-019-39997-3.

  25. Wang, Yincang, Xiaodong Li, Hang Lv, Lin Sun, Bo Liu, Xiaofeng Zhang, and Xilin Xu. “Therapeutic Potential of Naringin in Improving the Survival Rate of Skin Flap: A Review.” Frontiers in Pharmacology 14 (March 2, 2023): 1128147. https://doi.org/10.3389/fphar.2023.1128147.

  26. Wise, Lyn M., Gabriella S. Stuart, Nicola C. Jones, Stephen B. Fleming, and Andrew A. Mercer. “Orf Virus IL-10 and VEGF-E Act Synergistically to Enhance Healing of Cutaneous Wounds in Mice.” Journal of Clinical Medicine 9, no. 4 (April 11, 2020): 1085. https://doi.org/10.3390/jcm9041085.

  27. Yen, Jia-Hau, Wan-Ting Chio, Chia-Ju Chuang, Hsin-Ling Yang, and Sheng-Teng Huang. “Improved Wound Healing by Naringin Associated with MMP and the VEGF Pathway.” Molecules 27, no. 5 (March 4, 2022): 1695. https://doi.org/10.3390/molecules27051695.

  28. Zhang, Lei, Raffaella De Salvo, Sonja Trapp, Walter Wigger-Alberti, Ragna Williams, Lucie Delcour, Bart Rossel, and Maarten T. Huisman. “Evaluation of BepanGel Hydrogel Efficacy and Tolerability Using an Abrasive Wound Model in a Within-Person, Single-Center, Randomized, Investigator-Blind Clinical Investigation.” Dermatology and Therapy 10, no. 5 (October 2020): 1075–88. https://doi.org/10.1007/s13555-020-00432-5.

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