GOLD: human exposure and update on toxic risks.

Gold is ubiquitous in the human environment and most people are in contact with it through wearing jewelry, dental devices, implants or therapies for rheumatoid arthritis. Gold is not a nutrient but people are exposed to it as a food colorant and in food chains. The present review discusses the hazards faced in personal and domestic use of gold and the far greater risks presented through occupational exposure to the metal in mining and processing gold ores.

Metal ions affecting the skin and eyes.

The skin and eyes remain in constant exposure to the surrounding environment and are subject to accidental, occupational, and biological risks at all times, Normal development, homeostasis, and repair following injury depend upon appropriate levels of calcium, zinc, magnesium, copper, iron, and minute amounts of other trace metals. Both tissues exist in a permanent state of dynamic equilibrium with the environment whereby cells lost through natural wear and tear are replaced through genetically regulated mitotic patterns. Normal functional requirements of the constituent tissues depend on critical balances between trace metals, metal ion gradients, and specific carrier proteins which are modulated by upregulation of growth factors, cytokines, hormones, and subcellular regulators acting by autocrine, paracrine, and endocrine mechanisms.

A pharmacological and toxicological profile of silver as an antimicrobial agent in medical devices.

Silver is used widely in wound dressings and medical devices as a broad-spectrum antibiotic. Metallic silver and most inorganic silver compounds ionise in moisture, body fluids, and secretions to release biologically active Ag(+). The ion is absorbed into the systemic circulation from the diet and drinking water, by inhalation and through intraparenteral administration.

The role of the pathologist in wound management.

Skin wounds result from a wide variety of physical insults, traumas and idiopathic causes. All are prone to infection and vulnerable to dehydration, contamination and further damage from environmental insult. Appropriate therapy depends upon correct diagnosis of the lesion, wound bed preparation with antimicrobial measures as required, and selection and application of suitable dressings.

Zinc in wound healing: theoretical, experimental, and clinical aspects.

Zinc is an essential trace element in the human body and its importance in health and disease is appreciated. It serves as a cofactor in numerous transcription factors and enzyme systems including zinc-dependent matrix metalloproteinases that augment autodebridement and keratinocyte migration during wound repair. Zinc confers resistance to epithelial apoptosis through cytoprotection against reactive oxygen species and bacterial toxins possibly through antioxidant activity of the cysteine-rich metallothioneins.

Silver in health care: antimicrobial effects and safety in use.

Silver has a long and intriguing history as an antibiotic in human health care. It has been developed for use in water purification, wound care, bone prostheses, reconstructive orthopaedic surgery, cardiac devices, catheters and surgical appliances. Advancing biotechnology has enabled incorporation of ionizable silver into fabrics for clinical use to reduce the risk of nosocomial infections and for personal hygiene.

A guide to the properties and uses of silver dressings in wound care.

Silver-release dressings are extensively used for wound management, particularly in the treatment of burns, chronic leg ulcers and wounds requiring an antibacterial. A variety of products is now available. The properties and uses of these dressings are discussed, followed by a review of advances over recent years

Nutrition 2: a vital consideration in the management of skin wounds.

The first part of this review focused on the essential biological features of human skin, their origins and cellular relationships as a basis for understanding nutritional requirements in health and disease (see Vol 13 (19; Tissue Viabil Suppl): S22-S28). The second part will discuss the importance of a good, well-balanced diet sufficient in proteins (amino acids), fats, carbohydrates, vitamins and minerals in the management of skin wounds. Evidence is drawn from clinical trials, case studies of patients with known genetic deficiencies affecting dietary metabolism and metabolic studies.

Nutrition 1: a vital consideration in the management of skin wounds.

Nutrition is a provocative subject in tissue repair, particularly in relation to the skin which consists of many different tissues fulfilling various essential functions. This article, the first in a two-part series, will discuss the structure of the human skin and its variations, with indications as to the individual requirements of the cells in fulfilling their normal role in skin physiology and in repair systems. Nutrient gradients seem to play a major role in normal skin physiology and repair systems following injury.

A review of the use of silver in wound care: facts and fallacies.

This review traces the use of silver in wound care, discussing its merits as an antibacterial agent and constituent of many new dressings, which are increasingly tailored to the treatment of wounds ranging from acute surgical lesions to chronic and diabetic leg ulcers. Misconceptions regarding the biological properties of silver, its possible physiological value in the human body and wound bed, absorption through the skin, and safety factors are addressed. The article aims to present silver and the new range of sustained silver-release dressings as important features in the management of skin wounds, providing effective control of wound infections while ensuring patient comfort and quality of life.

Calcium: a potential central regulator in wound healing in the skin.

Calcium has an established role in the normal homeostasis of mammalian skin and serves as a modulator in keratinocyte proliferation and differentiation. Gradients of calcium concentration increasing from 0.5 mM in the basal layer to > 1.

Metallothioneins: potential therapeutic aids for wound healing in the skin.

Metallothioneins are a family of low molecular weight proteins containing approximately 30 % cysteine. Expression of the metallothionein gene is up-regulated in the skin following topical application of zinc and copper, and in wound margins particularly in regions of high mitotic activity. This induction of metallothionein in the wound margin may reflect its role in promoting cell proliferation and reepithelialiation.