Wound healing associated with severe surgical illness.

Severe injury or infection is associated with a hypermetabolic response that, when excessive, results in impaired wound healing and as a consequence increased morbidity and mortality. The objective examination of wound healing in humans is difficult and generally requires the use of models. Evidence is accumulating that nutritional and growth factors play important roles in improving the wound healing response, particularly after thermal injury and uncomplicated major surgery. The septic patient represents the biggest challenge to those seeking to optimize wound healing capacity. Advances in molecular biology have provided promising therapies in experimental studies of wound healing that await clinical investigation.