Environmental, Nutritional, and Therapeutic Factors That Affect Surgical Wound Healing: A Narrative Review of Experimental Findings From the Last 5 Years.

Abstract

Wound healing is a crucial aspect of clinical outcomes following surgical procedures. Various physiological, environmental, and lifestyle factors impact healing time and quality. This review is based on the latest experimental findings pertaining to surgical wound management and healing, based on a PubMed search of experiments from the last 5 years. Topics of interest were infection control, nutrition, radiation-induced skin injury (RSI), and closed-incisional negative pressure wound therapy (CiNPWT). The study mainly assesses wound healing by primary intention and focuses on easily implemented therapies. 403 articles were screened regarding infection prevention with 336 excluded based on title and preview of content. 67 abstracts were further reviewed which yielded 32 articles for analysis. Overall, povidone-iodine is shown to improve the rate of wound healing and helps minimize complications such as infections or wound dehiscence while creating a sterile field due to its antimicrobial properties. It remains a standard of comparison for other anti-infectives. Nutritional factors such as veganism may impair surgical wound healing, whereas maintaining appropriate albumin levels may be protective. Employment of nutritional screenings may improve overall outcomes post-operatively, and oral probiotics improve soft tissue healing after incision, in at least one study. Pycnogenol® and Centellicum® may have applications to improve surgical site healing, since supplementation demonstrates improved perfusion and other favorable metrics. Management of RSI is a field of much exploration, with many topicals shown effective. Recently, hydrogels and even injection of stromal vascular factor show promising results. CiNPWT is found to improve overall surgical outcomes in diverse wounds, and sponge width is an important consideration. Consideration of the findings discussed, along with their potential combinations and applications, may serve to improve surgical wound healing.