Role of sugar-based compounds on cutaneous wound healing: what is the evidence?
Abstract
Cutaneous wound healing is a complex orchestrated process influenced by many endogenous and exogenous imbalances. The main goal of tissue regeneration in wound healing is to increase wound contraction and reduce scar formation, effectively to regenerate a new healthy epidermis and prevent scar contracture. Additionally, prevention, control and treatment of wound infections, particularly in burn wounds, is a vital strategy in the healing process. It was previously supposed that local application of sugar-based materials increases the chance of wound infection and delays wound healing. This review shows that topical application of sugar-based compounds has no negative effects on different wound types. Whereas, hyperglycaemia created by diabetes, stress or certain medications can act to impair wound healing. Therefore, this work was designed to review the recent studies that evaluated the role of sugar-based compounds on wound healing and to demonstrate in various cutaneous wound models how these compounds may be involved in healing. It also deals with different physio-pharmacologic conditions resulting in hyperglycaemia in different models of cutaneous wound healing in order to illustrate the role of endogenous glucose in wound healing and remodelling.
Factors such as penetration of harmful ultraviolet radiation, pathogens, overheating, accident, trauma, diabetes and many others can cause cutaneous wounds. Therefore, treatment of these wounds is technically demanding and wound healing is a vital process in the survival of all living creatures.1,2 Wound healing is a conserved evolutionary process that occurs in three overlapping stages: inflammatory, proliferative and remodelling.3–5 It involves extensive communication between different cellular constituents.3 Skin wounds heal without scar in the earlier ages of mammalian embryos, whereas in adults scar formation is the general mode of wound healing.6,7 However, the quality of wound healing depends on many characteristics such as type of wound, general condition of the patient and associated diseases.8 Depending on the healing stage, it is routinely classified as an acute or chronic wound. Mild trauma and ordinary surgical procedures lead to acute wounds that can be repaired in an orderly and timely process. It is estimated that 80% of chronic wounds are associated with venous or arterial insufficiency, decubitus, or diabetes, leading to major challenges in the repair process.9–11
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