Oxygen, pH, Lactate, and Metabolism-How Old Knowledge and New Insights Might Be Combined for New Wound Treatment

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dc.authoridDemircan, Mehmet/0000-0002-4022-1276
dc.authoridNischwitz, Sebastian P./0000-0002-6621-4891
dc.authoridHaller, Herbert/0000-0002-4996-4199
dc.authorwosidHaller, Herbert/AAN-5080-2021
dc.authorwosidDemircan, Mehmet/B-1904-2008
dc.contributor.authorHaller, Herbert Leopold
dc.contributor.authorSander, Frank
dc.contributor.authorPopp, Daniel
dc.contributor.authorRapp, Matthias
dc.contributor.authorHartmann, Bernd
dc.contributor.authorDemircan, Mehmet
dc.contributor.authorNischwitz, Sebastian Philipp
dc.date.accessioned2024-08-04T20:50:51Z
dc.date.available2024-08-04T20:50:51Z
dc.date.issued2021
dc.departmentİnönü Üniversitesien_US
dc.description.abstractOver time, we have come to recognize a very complex network of physiological changes enabling wound healing. An immunological process enables the body to distinguish damaged cells and begin a cleaning mechanism by separating damaged proteins and cells with matrix metalloproteinases, a complement reaction, and free radicals. A wide variety of cell functions help to rebuild new tissue, dependent on energy provision and oxygen supply. Like in an optimized bio-reactor, disturbance can lead to prolonged healing. One of the earliest investigated local factors is the pH of wounds, studied in close relation to the local perfusion, oxygen tension, and lactate concentration. Granulation tissue with the wrong pH can hinder fibroblast and keratinocyte division and proliferation, as well as skin graft takes. Methods for influencing the pH have been tested, such as occlusion and acidification by the topical application of acidic media. In most trials, this has not changed the wound's pH to an acidic one, but it has reduced the strong alkalinity of deeper or chronic wounds. Energy provision is essential for all repair processes. New insights into the metabolism of cells have changed the definition of lactate from a waste product to an indispensable energy provider in normoxic and hypoxic conditions. Neovascularization depends on oxygen provision and lactate, signaling hypoxic conditions even under normoxic conditions. An appropriate pH is necessary for successful skin grafting; hypoxia can change the pH of wounds. This review describes the close interconnections between the local lactate levels, metabolism, healing mechanisms, and pH. Furthermore, it analyzes and evaluates the different possible ways to support metabolism, such as lactate enhancement and pH adjustment. The aim of wound treatment must be the optimization of all these components. Therefore, the role of lactate and its influence on wound healing in acute and chronic wounds will be assessed.en_US
dc.description.sponsorshipPolymedics GmbH, Denkendorf, Germanyen_US
dc.description.sponsorshipLanguage editing costs and article processing costs were paid by Polymedics GmbH, Denkendorf, Germany. No further external funding was received. The company did not take any influence on the contents or results or kind of presentation of the paper.en_US
dc.identifier.doi10.3390/medicina57111190
dc.identifier.issn1010-660X
dc.identifier.issn1648-9144
dc.identifier.issue11en_US
dc.identifier.pmid34833408en_US
dc.identifier.scopus2-s2.0-85118695123en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.urihttps://doi.org/10.3390/medicina57111190
dc.identifier.urihttps://hdl.handle.net/11616/100299
dc.identifier.volume57en_US
dc.identifier.wosWOS:000725138500001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherMdpien_US
dc.relation.ispartofMedicina-Lithuaniaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectwounden_US
dc.subjectchronic wounden_US
dc.subjecthypoxiaen_US
dc.subjectacidosisen_US
dc.subjectalkalosisen_US
dc.subjectlactateen_US
dc.subjectneoangiogenesisen_US
dc.subjectECMen_US
dc.subjectpolylactideen_US
dc.titleOxygen, pH, Lactate, and Metabolism-How Old Knowledge and New Insights Might Be Combined for New Wound Treatmenten_US
dc.typeReview Articleen_US

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