What inhibits wound contraction?

From the Guidelines

The answer is (a) glucocorticoids, as they are potent inhibitors of wound contraction, which is a critical phase in the wound healing process. They work by suppressing inflammation, inhibiting fibroblast proliferation, and reducing collagen synthesis and deposition. These effects directly interfere with the myofibroblast activity necessary for wound contraction. Glucocorticoids also decrease the production of growth factors like TGF-β that are essential for proper wound healing. This is why long-term glucocorticoid therapy can lead to delayed wound healing and increased risk of wound complications. While the other options—d-penicillamine, colchicine, and aspirin—may affect certain aspects of wound healing, they do not specifically inhibit wound contraction to the same extent as glucocorticoids.

Some key points to consider when evaluating the effects of these options on wound healing include:

• The role of inflammation in wound healing and how glucocorticoids suppress this process 1
• The importance of growth factors like TGF-β in wound healing and how glucocorticoids decrease their production
• The potential benefits and drawbacks of using negative pressure wound therapy (NPWT) in wound management, as discussed in recent studies 1
• The lack of clear evidence supporting the use of certain treatments, such as NPWT, over conventional methods in all cases 1

However, glucocorticoids are the most well-established inhibitors of wound contraction. Clinicians should be cautious when prescribing glucocorticoids to patients with wounds or those undergoing surgery, as these medications may impair the normal healing process. It is essential to weigh the benefits and risks of glucocorticoid therapy in the context of wound healing and to consider alternative treatments when possible.

From the Research

Inhibitors of Wound Contraction

• Colchicine is a microtubule-disassembling drug that has been shown to inhibit microtubule polymerization, which affects various cellular processes including cell migration and contraction 2, 3, 4.
• The RhoA/Rho-associated kinase pathway plays a crucial role in wound healing and scar contracture, and inhibition of this pathway has been shown to hinder fibroblast contractility and prevent scar contracture 5.
• Other inhibitors of wound contraction include:
  • Fasudil, a Rho-associated kinase inhibitor, which has been demonstrated to inhibit wound contraction in a rat model of dermal wound healing 5.
  • ALK5 inhibitor A-83-01, which reduces burn wound contraction in rats by suppressing myofibroblast population 6.
• Among the given options, colchicine (c) is an inhibitor of microtubule polymerization and can be considered as an inhibitor of wound contraction due to its effects on cell migration and contraction 2, 3, 4.