UNDERSTANDING WOUND HEALING

The Basis of What We Do

WOUND HEALING & THERAPEUTICS

Chronic wound is a top healthcare problem in the 21st century with its number exceeding those with breast cancer, colon cancer, lung cancer and leukaemia combined. Its burden to healthcare cost is approximately US$20 billion and US$6.6 billion in United States and United Kingdom, respectively. This is in part fuelled by the increase in diabetes due to modern lifestyle, rising geriatric population and growing number of road accidents and trauma injuries.

Both global wound care and stem cell therapeutics markets are projected to be on an increasing trajectory growth in the next 5 to 7 years. Asia Pacific is expected to grow at a high pace in the coming years with increasing healthcare expenditure due to affluency and wider education outreach.

DEFINING THE TYPES OF WOUNDS

Acute Wound
  • Injury to skin that occurs suddenly rather than over time
  • Heals at predictable rate of normal wound healing processes
  • Includes surgical, traumatic wounds or burns


Chronic Wound
  • Injury that failed to progress through stages of healing in a timely and orderly fashion
  • Usually shown no significant progress towards healing in 30 days or even months
  • Includes diabetic foot ulcers, pressure ulcers, venous leg ulcers etc
Chronic wound alone account for the largest market size in wound management with US$ 9.91 billion in 2017. Thirty percentage of untreated wound resulted in amputation with 30% of amputees having a 50% mortality rate within 5 years.

WOUND HEALING IS A COMPLEX PROCESS

Depending on the severity (closed or open, depth of damage) of the wound, the healing process can occur through primary, secondary or tertiary intention that involve multiple stages with both intrinsic and extrinsic factors. Understanding the processes is the key to intervention.

1.
HEMOSTASIS
  • Vascular constriction & clot formation to prevent further blood loss
  • Release of histamine, chemostatic factors, cytokine & growth factors in preparation for inflammatory phase
2.
INFLAMMATION
  • Neutrophil infiltration & migration of macrophages to cleanse the wound of debris
  • Growth of fibroblasts
3.
PROLIFERATION
  • Proliferation of fibroblasts over the matrix within the bed of the wound
  • Covering the wound surface & restoration of vascular network through generation of granulation tissue
4.
REMODELLING
  • Wound contraction
  • Formation of granulation tissue stops
  • Remodelling of the collagen to increase tensile strength of the healing tissues
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