In the last decade our knowledge on tissue repair mechanisms and wound healing processes has increased rapidly, including possibilities to use new strategies to speed up these processes in connection with surgical innovations. In the meantime, technical improvement in various medical disciplines has made rapid advances with new joint, vascular and organ prosthesis materials. New polymer prosthesis materials have been introduced, and also new methods to combat the infection problems associated with the introduction of such material into the human body. New strategies for surgical procedures with ultra-clean air and surface release of antibiotics from bone cement, as well as new strategies for wound covering of large burns, have stimulated other areas of surgery to develop methods for prevention and treatment of biomaterial-associated infections. The great problems in modern vascular surgery, emphasized already more than a decade ago by Duma , have encouraged research activity in this area to elucidate graft associated infections. During this decade rapid advances in molecular biology have created an expansion of our understanding of how surgical and other infections invade at the molecular level. Besides our old knowledge on how pathogens such as staphylococci and Pseudomonas aeruginosa cause tissue damage in surgical and wound infections by a variety of extracellular toxins and enzymes, we also know that certain capsular polysaccharides give the organism anti-phagocytic properties in the wound (and experimental capsular vaccines have been developed). However, it is not until very recently that we have begun to understand how wound pathogens, such as a great variety of mucosal surface organisms, seem to colonize wound tissues by specific mechanisms induced by the binding of surface molecules to fibronectin, collagen and other connective tissue matrix proteins.
KeywordsPolysaccharide Pseudomonas Hunt Staphylococcus
- 1.Duma RI. Infections of prosthetic heart valves and vascular grafts. Prevention Diagnosis and Treatment, University Park Press, 1977Google Scholar
- 4.Barbul A, Pines E, Caldwell M, Hunt T. Growth factors and other aspects of wound healing. Progress in Clinical and Biological Research 266, 1987Google Scholar