Wound healing in sepsis and trauma

Wound healing represents a dynamic and immediate response of the body to tissue injury with the purpose of restoring anatomical continuity, structure and function. Success or failure of this complex cascade of events is determined largely by competence of the host's immune system. Sepsis represents one of the most formidable threats to successful wound healing. It can present as a local bacterial colonization of the injury site with minimal systemic reaction or the "systemic inflammatory response syndrome," a primary cause of mortality among critically ill patients. Trauma also predisposes patients to wound complications especially as a result of post-traumatic immunosuppression. This phenomenon exposes the patient to the risk of microbial infection and ultimately the sepsis syndrome. The immune system, therefore, represents a vulnerable gateway through which trauma and sepsis exert their deleterious effect on the wound healing process resulting in increased morbidity and mortality for the surgical patient.