Impact of Ischemia on Tissue Oxygenation and Wound Healing: Improvement by Vasoactive Medication

Abstract

Wound healing is a complicated process, accomplished by a variety of interrelated metabolic pathways. Disturbances of any of these aspects will result in impaired wound healing. Besides generalized diseases like diabetes mellitus and immunodeficiencies, systemic or local infections can jeopardize tpe normal wound healing process. Finally, chronic ischemia due to inadequate tissue perfusion and oxygenation can have protracting or deletary effects on the process of wound healing. Inadequate tissue oxygenation results from a discrepancy between oxygen demand and oxygen supply to the impaired tissue. These pathologic conditions include both acute states of ischemia following trauma as well as chronic ischemia in peripheral arterial disease and chronic venous insufficiency. A variety of therapeutic interventions are used to improve the perfusion and oxygenation of the endangered tissue. Elimination of risk factors like cigarette smoking and hypercholesteremia, physical exercise, surgical interventions (bypass, sympathectomy etc.) and finally pharmacological approaches have been studied, with the aim to achieve increased tissue perfusion and improvement of the rheological properties of the blood.