Immobilised heparin accelerates the healing of human wounds in vivo

Locally produced growth factors are of great importance in wound healing in human skin. Wound fluid from chronic wounds contains low concentrations of growth factors possibly because of rapid degradation as a result of the hi gh concentration of proteases. Many growth factors involved in wound healin g bind to heparin and are thereby stabilised and activated. We have recentl y shown that heparin in combination with chitosan stimulates re-epitheliali sation in an in vitro model of human wound healing. In the present study we investigated the effects of a chitosan-heparin membrane on wound healing i n 10 split-thickness graft donor sites in human skin. The chitosan-heparin membrane stimulated healing of the donor sites both when judged macroscopic ally in a blinded fashion and when biopsy specimens from the treated and un treated parts of the wound were investigated microscopically. We hypothesis e that the beneficial effects of the chitosan-heparin membrane result from slow release of heparin into the wound area which protects locally produced growth factors. The result is increased stabilisation and concentration of growth factors in the wound area, which stimulate healing. We believe that these results may be important in the treatment of wounds that are relucta nt to heal.