Physiology and pharmacology of wounds

A wound is a condition in which the epithelium cell structure is damaged following an injury due to chemicals, surgery, cut, extreme heat and cold, shear force, or diseases such as ulcers and carcinomas. Wounds may be categorized as open, closed, acute, chronic, healing, and nonhealing type depending on numerous factors. All living organisms have the characteristics to heal or repair wounds on their own. The wound healing process consists of different overlapping phases such as hemostasis, inflammation, proliferation, and remodeling. Several signaling molecules and cells are involved in wound pathogenesis such as damage-associated molecular patterns, pathogen-associated molecular patterns, mast cells, neutrophils, macrophages, and monocytes. Inflammation, hypoxia, and temperature are conditions that play a significant role in the wound physiology and healing process. Various diseases or conditions such as diabetes, CNS injuries, burns, infection, AIDS, tuberculosis, leprosy, cancer, hemophilia, and COVID-19 have a significant association with wound physiology. Some types of wounds are not able to be healed by living organisms; therefore, there is a need for proper and effective treatment and management of the wound. Wounds can be treated through traditional and modern approaches. Physiologically, wounds are treated through various steps such as the use of anti-infective agents, debridement, use of antimicrobials, surgical dressings, vacuum-assisted closure or negative pressure therapy for diabetic foot ulcers, reepithelialization using bioengineered dressings, hyperbaric oxygen, nutrients, and use of analgesic and antiinflammatory medicines. Nanoparticles such as hydrogel, liposomes, nanoemulsions, and polymeric particles are also used in wound management. In this chapter, we have discussed the detailed physiology of the wounds correlating the association of various conditions and diseases with wounds and their healing process. We have also discussed the pharmacological treatments used to manage the wound effectively, especially herbal therapy and novel drug delivery system such as nanoparticles.