[Wound healing: from polypragmasy to rational therapy concepts--can growth factors contribute anything?]

Impaired wound healing as seen in diabetic, arterial, venous and decubital ulcers is still an unsolved problem. The lack of precise knowledges of wound pathophysiology renders efficient therapeutic approaches difficult. Many local and systemic factors are delaying wound repair, e.g., tissue ischemia, intra- and extravascular fibrin depositions, vasodilatation of the non-nutritive microcirculation, necrosis, infection, impaired migration of the epithelial cells of the ulcer edge and an inadequate cytokines pattern. With regard to these factors general therapeutic measures are proposed. We believe that in the near future cytokines may substantially improve our actual treatment methods of chronic ulcers.