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EPMA J. 2017 Mar 3;8(1):23-33. doi: 10.1007/s13167-017-0081-y. eCollection 2017 Mar.

Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine.

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Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Radiological Clinic, Medical Faculty, Friedrich-Wilhels-University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.


Whereas the physiologic wound healing (WH) successfully proceeds through the clearly defined sequence of the individual phases of wound healing, chronic non-healing wounds/ulcers fail to complete the individual stages and the entire healing process. There are many risk factors both modifiable (such as stress, smoking, inappropriate alcohol consumption, malnutrition, obesity, diabetes, cardio-vascular disease, etc.) and non-modifiable (such as genetic diseases and ageing) strongly contributing to the impaired WH. Current statistics demonstrate that both categories are increasingly presented in the populations, which causes dramatic socio-economic burden to the healthcare sector and society at large. Consequently, innovative concepts by predictive, preventive and personalised medicine are crucial to be implemented in the area. Individual risk factors, causality, functional interrelationships, molecular signature, predictive diagnosis, and primary and secondary prevention are thoroughly analysed followed by the expert recommendations in this paper.


Cancer; Cardio-vascular disease; Diabetes; Flammer syndrome; Impaired healing; Predictive preventive personalised medicine; Wound

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