IMMUNOLOGICAL REACTIONS IN CHRONIC WOUNDS

Although healing is initiated by local inflammation, excessive or prol onged inflammation may delay healing and increase scar potential. Infl ammatory cascades in the wound's microenviromnent are triggered by com plement degradation products; polymorphonuclear leukocyte products; ox ygen free radicals; enzymes, particularly proteinases; and microbial p roducts. Infection, ischemia, necrotic or severely damaged tissue, or foreign matter propel and prolong inflammation and challenge host defe nses, leaving the patient susceptible to farther microbial invasion. O cclusion dressings can minimize necrotic tissue by preventing desiccat ion, aiding debridement, and providing a barrier against exogenous pat hogenic organisms, thus limiting the resulting inflammatory cascade.