Statins enhancing wound repair
A recent study by Nassaji, Ghorbani and Shkofte concluded that Atorvastatin may have a role in preventing diabetic foot related infections. They point out that whilst statins have a lipid-lowering effect, they also demonstrate anti-inflammatory and immunomodulatory actions. Their observations are supported by work done by Fitzmaurice and colleagues. Fitzmaurice et al report the wound healing benefits of statins include faster re-epithelialization, increased wound-breaking strength, enhanced angiogenesis, lower inflammatory reaction and reduction in hypertrophic scar formation. A risk noted with statin use however was the predisposition towards haematoma formation. At present there is little data to guide the use of statins in clinical wound care. The type of wounds best suited to this treatment is unclear although both surgical and diabetic foot wounds have been investigated to date. Topical versus systemic administration along with dosage, duration and the timing of treatment are yet to be elucidated into guidelines. Likewise how topical statin application is impacted by wound debris and exudate has not been explained, although the debridement of devitalised surface tissue would seem a reasonable expectation prior to any topical therapeutic agent being employed. Further developments will certainly be viewed by wound care clinicians with interest.
Nassaji,M Ghorbani,R Shkofte,HS Previous Atorvastatin treatment and risk of diabetic foot infection in adult patients: a case-control study. Wounds 2017;29(7):196-201
Fitzmaurice,GJ et al Do statins have a role in the promotion of postoperative wound healing in cardiac surgical patients? Ann Thorac Surg 2014;98:756-764