The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.

/pdf/psychological-stress-and-the-human-immune-system-a-meta-3lp53rp4yz.pdf

Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry

Greater interest in wound healing is needed to ensure higher standards of basic care. Precise identification of the systemic, local, and molecular factors underlying the wound healing problem in individual patients should allow better tailored treatment. Allogeneic skin grafting and bioengineered skin equivalents are being used successfully in patients with venous leg ulcers and diabetic patients with foot ulcers.

https://www.bmj.com/content/bmj/324/7330/160.full.pdf

Science, medicine and the future: healing chronic wounds.

Wound healing: Biologic features and approaches to maximize healing trajectories

Acute wound healing involves a complex series of events including chemotaxis, cell division, neovascularization, synthesis of new extracellular matrix, and the formation and remodelling of the scar tissue. These events are regulated by several mediators including platelets, inflammatory cells, cytokines and growth factors, and matrix metalloproteinases and their inhibitors. In acute wounds, these processes (which are triggered by tissue injury) involve the four overlapping (but well-defined) phases of haemostasis, inflammation, proliferation, and remodelling; an avascular scar is the final stage of the wound healing process. In contrast to this, some wounds fail to heal in a timely and orderly manner, resulting in chronic non-healing wounds. Alterations in one or more of these components could account for the impaired healing observed in chronic wounds because cytokines, growth factors, proteases, and cellular and extracellular elements all play important roles in different stages of the healing process. Also, dysregulation in certain stages of the healing process could result in excessive deposition of collagen and formation of abnormal scar, as seen in hypertrophic scars and keloids. In this review, the cellular and molecular events involved in acute wound healing and the mechanisms resulting in abnormal healing are discussed; the various types of wound healing are also discussed.

Basic science of wound healing

https://www.annemergmed.com/article/S0196-0644(88)80351-2/pdf

The physiology of wound healing.

Foreword 1. Wounds: the extent of the burden 2. History of wound healing 3. The biology of healing 4. Surgical wounds 5. Experimental models in wound healing 6. Factors influencing wound healing 7. Infection 8. Management of traumatic wounds 9. Clinical aspects of healing in specialized tissue 10. Clinical aspects of healing by secondary intention 11. Wound dressings 12. Clinical trials and statistics 13. The future of wound healing

Wounds : biology and management

Collagen is structurally and functionally a key protein of the extracellular matrix which is also involved in scar formation during the healing of connective tissues. Many collagen dressings have been developed to enhance wound repair, particularly of non-infected, chronic, indolent skin ulcers. The use of collagen dressings is supported by relatively sparse and insufficient scientific data. This review identifies the supporting evidence for the use of the dressings which are available, often with widely different claimed advantages and modes of action, and considers future developments and assessment of collagen dressings.

Role of collagen in wound management

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Wounds : biology and management

Role of collagen in wound management