The Importance of Proteases in Wound Healing and Wound Assessment

REFERENCES Dr Robert Snyder, Tamarac, Florida Dr Tom Serena, Warren, Pennsylvania Dr Breda Cullen, Lorraine Nisbet, Systagenix, Gatwick , UK Proteases have various roles in wound healing such as the migration and activation of fibroblasts, extra cellular matrix remodelling and growth factor activation. However, in some non-healing chronic wounds, protease activity remains at an elevated level which impairs wound healing and can lead to chronic inflammation .The impact of elevated protease activity on wound healing is being discussed more frequently clinically and the need to control these proteases is being considered in the selection of treatment for chronic wounds. A number of signs and symptoms are being used to alert the clinician to chronic inflammation and potential elevated protease activity. These include swelling, pain, colour, fibrin deposition and pebbled granulation tissue, to name but a few, but at present there is no visual assessment that conclusively indicates the presence of elevated protease activity in the wound microenvironment. As this is a developing field in the wound healing arena, a survey was carried out to assess the clinical importance, relevance and current understanding of proteases and their impact on wound healing and treatment choice. A survey was carried out to establish the clinical importance and current understanding of proteases and their impact on wound assessment and treatment choice. The results presented here are the results and conclusions from this survey. A 22 question survey was prepared by a leading wound care clinician and sent to over 500 registered wound care professionals’ and clinicians from a range of disciplines. Their responses were collected and analysed. METHOD RESPONDENT DEMOGRAPHIC N = 181 What is your professional title? Physician Podiatrist Physician Assitant Physical Therapist Advanced Registered Nurse Pracitioner Registered Nurse Licensed Practical Nurse Other 16 6 11 30