The microenvironment of wound healing.

This review summarizes experiments performed by us and others, examining the importance of the microenvironment to wound healing. The development of a sealed polyurethane wound chamber has allowed us to perform studies evaluating the effects of growth factors, transplanted cells, and other bioactive substances on wound healing. Studies have compared wet, moist, and dry healing, with the conclusion that a wet, incubator-like microenvironment provides the fastest healing with fewest aberrations and least scar formation. The wet environment is also paramount for the survival and proliferation of transplanted cells or tissue, which has been shown in studies of porcine and human wounds. Moreover, high concentrations of antibiotics and other agents can be introduced in the wound chamber, thereby effectively fighting infection, while maintaining safe systemic concentrations. These findings have been used in clinical settings to treat wounds of different types. A titanium chamber has been developed to create an in vivo incubator, which will serve as a regenerative platform for in vivo tissue engineering.