Inhibitor of Wound Contraction

Glucocorticoids are the most significant inhibitor of wound contraction among the listed options. 1, 2

Mechanism of Action of Each Option

Glucocorticoids significantly inhibit wound contraction through multiple mechanisms 2:
- Interfere with inflammation, fibroblast proliferation, and collagen synthesis
- Antagonize various growth factors and cytokines essential for wound healing
- Form a "repressosome complex" consisting of glucocorticoid receptor, beta-catenin, and coactivator-associated-arginine-methyltransferase-1 that inhibits key wound healing markers 3
Both exogenous and endogenous glucocorticoids have been demonstrated to inhibit wound contraction in multiple studies 4, 5
Patients receiving medium to high-dose glucocorticoid therapy should be monitored for impaired wound healing 1

While d-penicillamine has some effects on collagen metabolism, it is not primarily recognized as an inhibitor of wound contraction 1
The evidence does not support d-penicillamine as a significant inhibitor of wound contraction compared to glucocorticoids

Colchicine primarily inhibits microtubule polymerization and has anti-inflammatory properties 1
It is mainly used for treating gout flares rather than being recognized for inhibiting wound contraction 1
The evidence does not indicate a significant role of colchicine in inhibiting wound contraction

Aspirin (acetylsalicylic acid) is an NSAID that inhibits cyclooxygenase enzymes 1
While it may delay some aspects of wound healing through its anti-inflammatory effects, it is not specifically identified as a significant inhibitor of wound contraction 1
NSAIDs like aspirin are recommended for conditions like gout but are not recognized as major inhibitors of wound contraction 1

Multiple studies have demonstrated that glucocorticoids prevent normal wound contraction 4, 2
Research shows that immunosuppression induced by glucocorticoids prevents normal wound contraction and normal increases in tensile strength 4
Studies in mice with defective glucocorticoid receptors (GR(dim) mice) showed enhanced ability to contract collagen, further supporting the inhibitory role of normal glucocorticoid function on wound contraction 5
While vitamin A can restore some aspects of wound healing impaired by glucocorticoids, it specifically "does not reverse the detrimental effects of glucocorticoids on wound contraction" 2
Experimental studies have shown that concurrent administration of other agents with cortisone had "no effect on restored body weight loss or inhibited wound contraction" 6

Healthcare providers should be aware of the possible occurrence of delayed wound healing in patients on glucocorticoid therapy 1
The inhibitory effect of glucocorticoids on wound contraction is particularly important in surgical settings, where they can cause dehiscence of surgical incisions 2
The inhibitory effects of glucocorticoids on wound healing occur through multiple pathways, making them more potent inhibitors than the other listed options 2, 3