Effects of experimental diabetes, uremia, and malnutrition on wound healing

The strength of linear wounds was studied in normal and diabetic rats in the first 8 wk after wounding. The strength of wounds from diabetic animals was found to be reduced compared with normal controls but could be improved by insulin treatment, especially when excellent metabolic control was achieved. There appeared to be both quantitative and qualitative defects in the formation of wound tissues in diabetic animals, because wound strength was not normalized when the thinner skin of diabetic animals was taken into consideration. This was different from the findings in rats with renal failure or malnutrition: in these two conditions, wound strength appeared reduced but was normalized when adjusted for skin thickness. Increased activity of aldose reductase did not appear to be an important factor in the impairment of wound healing in diabetes, because wound strength was not corrected by treatment with sorbinil, an aldose reductase inhibitor. The precise mechanism of abnormal wound strength in diabetes remains to be studied further, but careful control of diabetes, maintenance of nutrition, and treatment of systemic illness are important factors in the promotion of wound healing.