TREATMENT OF CHRONIC PURULENT WOUNDS BASED ON PATHOGENETIC MECHANISMS INVOLVING PROTEASES AND PROTEASE INHIBITORS

Abstract

Chronic purulent wounds represent a major challenge in modern surgery and wound care due to prolonged inflammation, excessive tissue destruction, and impaired healing. Increasing evidence indicates that dysregulation of proteolytic activity is a central pathogenetic mechanism responsible for wound chronicity. Elevated levels of matrix metalloproteinases (MMPs) and serine proteases, combined with insufficient activity of endogenous protease inhibitors, result in degradation of extracellular matrix components and inactivation of growth factors. This review summarizes current evidence from published studies over the last decade focusing on the role of proteases and protease inhibitors in chronic purulent wounds and highlights therapeutic strategies aimed at restoring protease–inhibitor balance.