PRIME Journal Vol. 9 Issue 6

MANAGEMENTOF OXIDATIVE STRESS AFTERAESTHETIC PROCEDURES AlfredMarchal explains the four stagesof thewoundhealing process inplastic surgeryanddermatology A FTER AN AESTHETIC procedure, many factors can interfere with the healing process, thus causing improper or impaired wound healing. The most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms are oxygenation 1 , infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. Therearefourstagestothewoundhealing process—coagulation, inflammation, proliferation, and remodelling 2,3 . Step 1: Coagulation The extravasation of blood into the wound is activated to limit the loss of blood. The clot, comprising of fibrin, fibronectin, vitronectin, Von Willebrand factor, and thrombospondin, provides the provisional matrix for cellular migration. Step 2: Inflammation Primary inflammation 24-48 hours The next wound healing stage is inflammation, with the activation of a classical molecular cascade, which leads to granulocytes or PMNLs (polymorph nuclear leukocytes) infiltrating the wound. These cells are attracted to the wound site within 24 to 48 hours of injury by a number of agents, such as C5a, platelets, TGF-beta, and formyl-methionyl peptide. Secondary inflammation 48-72 hours Monocytes are attracted to the wound by a variety of chemo-attractants, including clotting complements, immunoglobulin G (IgG), collagen and elastin, cytokines (such as leukotriene B4), platelet factor IV, PDGF, and TGF-beta. Macrophages are one of the most important cells present in the later stage of the inflammation process and act as key regulatory cells for repair. KEYWORDS Antioxidants, ROS, wound healing, inflammation There are four stages to the wound healing process— coagulation, inflammation, proliferation, and remodelling. ALFRED MARCHAL, PhD is an internationally recognised antioxidants and aesthetic medicine expert. He has a 35-year academic experience in R&D for pharmaceutical organic synthesis and phytopharmaceuticals. Author of many scientific articles and patents in particular for vitamin C, vitamin K and hyaluronic acid. He runs ALPHASCIENCE Research Department and is board member in pharmaceutical companies email a.marchal@alphascience.com ABSTRACT The most significant factors that affect cutaneous wound healing are oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. Oxidative stress reflects an imbalance between the systemic manifestation of reactive oxygen species (ROS) and a biological system’s ability to repair the resulting damage. It causes strand breaks in DNA. In humans, oxidative stress is thought to be involved in the development of many diseases and physical effects on the skin. The ROS play an important role in skin injury and repair but are required for the defense against invading pathogens, and at low concentrations, they are the crucial mediators of intracellular signalling. It’s very important to use antioxidant before and after aesthetics procedures. CLINICAL FEATURE | DERMATOLOGY | 20 November/December 2019 | prime-journal.com

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