Impact of drugs and diseases on wound healing
Wound healing is a highly complex process that can be impacted by drugs and diseases. Healing involves thousands of steps that all must be performed correctly, in the right order, and at the right time. The process is often divided into phases such as inflammatory, proliferative, and remodelling, but it is a continuous and overlapping process. Given the complexity of wound healing, it is not surprising that it can be affected by factors such as underlying diseases, medication, food additives, and other types of chemicals:
- It is known that if a more urgent condition develops, e.g. pneumonia, the body will withdraw resource from the wound healing process to concentrate on the pneumonia. Once this is under control, it will return to allocating resources to the wound healing process.
- There are many factors that will interfere with wound healing, but usually they will only reduce the speed of the process. It is rare that the interference is so strong that healing stops. However, if two or more drugs are affecting the same function but through different mechanisms healing can be strongly impaired because this makes it more difficult for the body to compensate for the interference.
- Proper nutrition is essential for wound healing. By proper nutrition is first and foremost meant not processed or ultra-processed food containing additives. These additives frequently interfere with the wound healing processes.
There will be medication that cannot be avoided or replaced by alternatives. In these cases, it will be necessary to accept that the wound healing process may proceed slower than expected – however, it is very important to be aware of potential interactions to be able to make informed choices.
Below are first listed the drugs and other chemicals that we have noticed to affect healing; and secondly, the diseases and conditions for which an impact has been observed. The data are not based on formal studies, but reflect practical observations collected during the treatment of wounds with MPPT. Medical and scientific support for these observations are generally available.
How to check for interactions with wound healing
First, if it is a drug or food supplement, it is necessary to identify the chemical, generic or technical name of the drug or chemical. The name is usually given on the package insert but otherwise enter the brand name (the name on the packet) into the search engine and ask for the generic name.
Second, enter the generic name or drug class, e.g. “ibuprofen” or “NSAID”, or the name of the condition, e.g. “diabetes”, and combine it with “wound healing”, “immunosuppressant”, “infection” and variations of these words. Look through the list to see if any formal studies have been published in scientific or medical journals and whether they mention an inhibiting effect on wound healing or on the immune response. DO NOT use opinion statements, only actual studies. DO NOT trust AI generated summaries as they are usually wrong, e.g. they often conclude the opposite. If you see that something is said to support healing or the treatment of wound infection, assume that it means that it does not inhibit healing – to see a beneficial effect it must have been directly demonstrated.
Drugs, treatments, and chemical food additives
The information below reflects observations that have been made during the course of treating wounds in individuals who simultaneously were receiving medical treatment or had eaten food with additives. They are not formal studies but nevertheless represent practical information if a wound is not responding as expected. For example, the list may permit selecting a different drug that does not interfere with healing. Taking two drugs simultaneously, both of which strongly impact wound healing, can in some cases stop healing altogether. However, it is rare that healing is completely stopped – usually the impact is a reduction in speed of healing.
Please note, that the information below does not reflect specific interactions with Amicapsil or SertaSil, but are observations in relation to wound healing in general, i.e. this will be relevant to all treatment approaches.
| Type | Class | Description |
|---|---|---|
| Drug | Antibiotics | Antibiotics can be used in combination with MPPT, when treating infections that are not related to wounds. They should not be used in combination with MPPT for treating a wound as they will disrupt the effects of MPPT. For non-wound related infections, when starting and stopping a course of antibiotics, a transient effect on the wound will typically be seen, but the body normally adapts quickly. This is also seen for long-term treatment with antibiotics. A typical effect of an antibiotic on the wound is that slough hardens and becomes more intertwined with the soft tissue, thus is retained in the tissue and becoming more difficult to remove. |
| Drug | Antiseptics | Antiseptics kill microbes as well as new tissue the body makes to close the wound. They will therefore interfere with the wound healing process. The only time when an antiseptic can used in a wound is when a true pathogen is present that needs to be eradicated. This is typically only the case in trauma, blast, and bite wounds. Most wound infections are caused by bacteria living naturally on the body and in these cases the goal is to bring them back under control − not to eradicate them because their presence is required for healthy healing to proceed. If a wound is soiled and needs to be cleaned, consider using a non-antimicrobial, additive free soap or tap-water. |
| Drug | Pain relief | USE: Opioids, paracetamol and gabapentin have successfully been used in combination with MPPT without interfering with wound healing. DO NOT USE: NSAIDS such as ibuprofen and carprofen (rimadyl) interfere with the immune response and will impact healing. Combinations of opioids and antidepressants, e.g. tramadol, to increase the pain-relieving effect should not be used because antidepressants are known to impact healing. Nerve growth factor inhibitors: Bedinvetmab inhibits new skin formation and increases the risk of skin infection. |
| Drug | Antidepressants: | Serotonin is involved in wound healing and both SSRIs and tricyclic antidepressants have been seen to reduce the speed of wound healing. They have not been seen to stop healing when used alone. However, their tendency to stop healing is high when used in combination with other drugs and, as an example, the SSRI venlafaxine combined with omeprazole, a proton pump inhibitor, has been seen to completely inhibit healing. |
| Drug | Anti-inflammatory drugs | Inflammation is an integral part of the body's response towards infection and drugs that inhibit this response will interfere with healing. The most commonly used group is corticosteroids, e.g. prednisone and prednisolone, and they will usually very severely impair healing. This is also the case if used topically as they readily pass into the blood stream. |
| Drug | Immunosuppressant drugs | This drug class inhibits the immune response and will most likely result in delayed healing. |
| Food additives | Food additives | Food additives can have physiological effects beyond the reason for using them in food. For example, sourdough bread not made by the traditional method and the artificial sweetener sucralose have both been seen to impair the body's ability to control a wound infection. AVOID: Calcium proprionate (bread) − antimicrobial and will affect the gut and skin microbiome and has been shown to affect the immune response. Sorbic acid (bread, food) − antimicrobial and found to suppress the immune response. Sucralose (artificial sweetener) − effects on wound healing has been seen and it is known to reduce the immune response. |
| Drug | Prostaglandin antagonists | Galliprant is an antagonist to prostaglandine (E2 EP4), i.e. it inhibits this receptor. This system is involved in wound healing and consequently Galliprant is likely to impact wound healing. When combined with bedinvetmab (Librela) for pain, which targets nerve growth factor, wound healing is strongly impaired. |
| Drug | Proton pump inhibitor | Omeprazole is used for treating acid reflux, but it also affects the gut microbiome, and, when combined with the antidepressant Venlafaxine (SSRI), this completely inhibited wound healing. |
| Drug | Anticoagulants | Anticoagulants have not been observed to affect wound healing. Also, increased bleeding in wounds being treated with MPPT has not been observed. This includes persons receiving anticoagulants. |
| Chemical | Adhesive removers | Do not use on or near the wound. They can arrest healing for up to several weeks. |
| Chemical | Barrier cream | Non-active barrier creams such as Cavilon can be used on intact, non-affected skin around the wound to protect it against exudate. Do not use it in the wound itself. |
| Drug | Vaccines | A vaccine activates the immune system and will draw resources from other areas. For example, covid-vaccines were seen to interfere transiently with the wound healing process. |
| Drug | Statins | Statins are known to have antibiotic-like effects but no clear-cut effects on wound healing processes have been seen. |
| Drug | Diabetes drugs | Metformin and insulin when used correctly to control diabetes have not been seen to interfere with healing. On the contrary, poorly controlled blood-sugar levels is known to impair healing. |
| Drug | Blood pressure | Beta-blockers, e.g. bisoprolol, have not been seen to have direct effects on healing. |
| Drug | Antacids / reflux inhibitors | Several, e.g. Gaviscon, Maalox and Mylanta, are based on aluminium hydroxide and it has been shown that the aluminium is absorbed and will affect the organism. Aluminium is toxic and will affect kidneys and immune response. It will, therefore, also affect wound healing. |
| Drug | Allergy | Antihistamines affect the immune response and negative effects have been seen on wound healing. |
| Condition | Anal fistula | An anal fistula is a small fistula or tunnel that develops between the end of the bowel and the skin near the opening of the bottom (anus). The outer opening of the fistula typically looks like a wound and will frequently develop infection because matter from the gut continuously travels through it. MPPT can treat the soft tissue infection, but surgery is typically required to close the fistula at its starting point. |
| Disease | Cancer | If cancer leads to the development of an infected wound, MPPT will typically be able to remove the soft tissue infection, but there are no data to indicate that MPPT will have an effect on the cancer itself. |
| Disease | Diabetes | Diabetes is known to affect wound healing processes, but as long as blood sugar levels are reasonably well controlled, healing will normally proceed although at a slower pace. |
| Disease | Flu and Covid | Common viral infections will not directly interfere with healing, but the healing process will be affected as the body relocates its resources from healing the wound to fighting the virus. It is therefore not uncommon to see a transient impact on the wound. |
| Disease | Immunocompromised conditions | Conditions involving impaired immune response will generally affect the ability to fight infection and wound healing. Usually, it will require the treatment with MPPT to continue until full wound closure. |
| Disease | Lupus | Chronic autoimmune disease where the body's immune system mistakenly attacks healthy tissues. It is usually treated with immunosuppressant medication, which will interfere with healing. However, MPPT has treated wounds in persons with Lupus successfully. |
| Disease | Multiple Sclerosis | Multiple sclerosis (MS) is a chronic, often disabling disease that affects the brain and spinal cord. It's an autoimmune condition where the body's immune system damages the myelin sheath around the nerve fibres. Some patients experience impaired wound healing and MPPT is effective in treating their wounds. Similarly to patients with SCI, treatment until full wound closure is typically required. |
| Condition | Osteomyelitis | Osteomyelitis, i.e. bone infection will continuously produce infectious debris that is expelled from the bone into the surrounding tissue. The body will, in response, create a canal, a draining fistula, to the skin surface through which this debris can escape − this usually looks like a normal wound from the outside, but it is not a wound and it cannot be closed until the osteomyelitis has been removed. This draining fistula needs to remain open to allow the debris to escape in order to prevent the infective debris to pool inside the soft tissue. The problem is that infection often develops around the draining canal, resulting in a large wound, often causing episodes of septicaemia and sepsis. MPPT will keep the canal open and can control the infection in the soft tissue. Osteomyelitis more than 6 weeks old can only be removed by surgery but, until this can take place, it is important to control the infection in the tissue. This also means that the bone surgery will be performed in non-infected soft tissue, thereby increasing the probability of a positive outcome. |
| Condition | Spinal cord injury | A spinal cord injury disrupts the communication between the immune system and the nervous system. This means that the nervous system cannot inform the immune system of an injury or an infection. The result is, for example, that 50% fewer immune cells are sent to the area where a new pressure injury has developed. SCI therefore decreases the ability to fight infection and heal wounds, and it also increases the risk of developing osteomyelitis (bone infection) if infection reaches the bone. The implications in relation to wound healing is that the use of Amicapsil needs to continue until full wound closure. Due to the increased risk of osteomyelitis, it is essential to treat a new wound as quickly as possible to avoid developing osteomyelitis. |
Wounds, ulcers and burns
Amicapsil for humans
Trauma and surgical wounds, pressure ulcers, venous leg ulcers, diabetic foot ulcers, burns, etc.
SertaSil for animals
Trauma and surgical wounds, abscesses, amputations, and burns in dogs, horses and other animals.
Dermatology
Aprobaxil for humans
Acne, pyoderma gangrenosum, hidradenitis suppurativa, atopic dermatitis, zits etc
Adinasil for animals
Eczema, dermatitis, lick granuloma, insect bites, autoimmune skin conditions, etc.