Topical Anti-inflammatory Agents in Wound Care
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The inflammatory phase is a crucial step in wound healing. Recently there was more attention to this aspect in terms of diagnostic procedures and therapeutic strategies.
The goal of caregiver should be to better understand when there is a necessity to provide the wound bed and surrounding skin with an anti-inflammatory therapy. The role of exudate on this matter is fundamental and more and more information have been provided to characterize the various cytokines in the exudate. In the last few years, there was an increasing interest about correcting-rebalancing the inflammation in various types of chronic wounds. The treatment ideally should bypass the systemic side effects of immunosuppressive agents considering the patient general status, which is most of the time affected by several other comorbidities. Topical agents with anti-inflammatory action have shown potential positive effects on chronic wounds. The range of topical agents in use at this time will range from matrix metalloproteinases inhibitors, anti-TNF alpha drugs, and nonsteroidal anti-inflammatory agents. Careful evaluation of wound bed and sometimes pathological assessment with a biopsy are mandatory before starting treatment. Level of pain will benefit also from those treatments according to the relation between pain and inflammation.
KeywordsChronic wounds Inflammatory phase Exudate Anti-inflammatory agents Cytokines Corticosteroids Metalloproteases Immunosuppression
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