Wound fluids: a reflection of the state of healing.

Analyzing acute and chronic wound fluids provides an important and intriguing insight into the wound milieu. This review outlines some of the salient features of wound repair and the wound fluid environment. Most studies support the premise that the contents of the wound fluid reflect the status of the wound and can be indicative of whether a wound is on the course of a normal or impaired response to injury. For example, chronic wound fluids often differ from acute wound fluids in their proliferative effects on cells active in healing as well as their proteolytic effects. The authors discuss various cytokines, growth factors, proteinases, and protease inhibitors within wound fluids as well as their effect on wound repair. This review also presents confounding factors affecting interpretation of wound fluid studies, suggesting that further studies need to elucidate mechanisms whereby wound fluids either enhance or inhibit wound repair. So far, wound fluid analysis has yielded tantalizing glimpses of the teeming wound environment. What wound fluid contents tell us about the wound or its clinical care is not yet certain.