PURPOSE OF REVIEW: The systemic inflammatory response to injury is essential for wound healing and recovery in concert with other endocrinological, metabolic and immunological changes. However, recent studies suggest that a hyperinflammatory state is associated with adverse perioperative outcomes. Therefore interventions that modulate the inflammatory response, surgical, anaesthetic and pharmacological, may enhance recovery with fewer complications. RECENT FINDINGS: Basic research on wound biology has shown the importance of genetic variability in determining the initial inflammatory response. Clinically, studies of cardiac surgery predominate in which genetic polymorphisms have been shown to result in a hyperinflammatory state. SUMMARY: The use of an interleukin-1 receptor antagonist to control wound pain and limit local inflammation is under consideration. The role of glucocorticoids in obtunding the inflammatory response to injury with improved outcome requires confirmation with better-quality trials. Systemic lidocaine is anti-inflammatory but is effective only in abdominal surgery. NSAIDs are neglected, despite their widespread clinical use and merit detailed investigation.
PURPOSE OF REVIEW: The systemic inflammatory response to injury is essential for wound healing and recovery in concert with other endocrinological, metabolic and immunological changes. However, recent studies suggest that a hyperinflammatory state is associated with adverse perioperative outcomes. Therefore interventions that modulate the inflammatory response, surgical, anaesthetic and pharmacological, may enhance recovery with fewer complications. RECENT FINDINGS: Basic research on wound biology has shown the importance of genetic variability in determining the initial inflammatory response. Clinically, studies of cardiac surgery predominate in which genetic polymorphisms have been shown to result in a hyperinflammatory state. SUMMARY: The use of an interleukin-1 receptor antagonist to control wound pain and limit local inflammation is under consideration. The role of glucocorticoids in obtunding the inflammatory response to injury with improved outcome requires confirmation with better-quality trials. Systemic lidocaine is anti-inflammatory but is effective only in abdominal surgery. NSAIDs are neglected, despite their widespread clinical use and merit detailed investigation.
Authors: James T Niemann; Scott T Youngquist; Atman P Shah; Joseph L Thomas; John P Rosborough Journal: Resuscitation Date: 2012-06-07 Impact factor: 5.262
Authors: Andrea Gray; Ileana Marrero-Berrios; Jonathan Weinberg; Devasena Manchikalapati; Joseph SchianodiCola; Rene S Schloss; Joel Yarmush Journal: Int Immunopharmacol Date: 2016-02-06 Impact factor: 4.932
Authors: Chamaidi Sarakatsianou; Konstantinos Perivoliotis; George Tzovaras; Athina A Samara; Ioannis Baloyiannis Journal: In Vivo Date: 2021 Nov-Dec Impact factor: 2.155