A 55-year-old man is evaluated due to a nonhealing left forearm wound. The patient had an excisional biopsy of a suspicious skin lesion at the site of the wound several weeks ago. He has a history of uncontrolled type 2 diabetes mellitus and hypertension. Vital signs are within normal limits. Physical examination shows a 2.5-cm wound surrounded by erythema on the left forearm. Upregulation of which of the following would most likely improve fibroblast proliferation and reepithelization in this nonhealing wound?

Question

A 55-year-old man is evaluated due to a nonhealing left forearm wound.  The patient had an excisional biopsy of a suspicious skin lesion at the site of the wound several weeks ago.  He has a history of uncontrolled type 2 diabetes mellitus and hypertension.  Vital signs are within normal limits.  Physical examination shows a 2.5-cm wound surrounded by erythema on the left forearm.  Upregulation of which of the following would most likely improve fibroblast proliferation and reepithelization in this nonhealing wound?

Quizplus · Accepted Answer

Eductional Objective: Elevated blood glucose induces the release of reactive oxygen species and proinflammatory cytokines from neutrophils while inhibiting the production of anti-inflammatory cytokines (eg, IL-10) and growth factors needed for fibroblast proliferation and reepithelialization in a healing wound.  As a result, patients with uncontrolled diabetes frequently have nonhealing wounds with evidence of ongoing inflammation.

A 55-Year-Old Man Is Evaluated Due to a Nonhealing Left