Could statins help speed up wound healing after cardiac surgery?


Could statins help speed up wound healing after cardiac surgery?


Patients who undergo cardiac surgery often have underlying health problems that can slow down the healing of their wounds. This could be set to change; a systematic review carried out recently has suggested that statins, drugs commonly used to lower cholesterol, could be used to speed up the healing process.

The researchers believe that statin therapy could speed up the wound healing process for all forms of surgery, not just cardiac procedures such as vein harvesting.

Gerald Fitzmaurice, of Our Lady's Children's Hospital in Dublin, Ireland, and lead author of the review published in The Annals of Thoracic Surgery, describes the drug:

"Statins have become one of the most widely prescribed medications in the world. While they are typically used to manage high cholesterol levels, a number of researchers have been investigating the benefits of statins in other conditions, such as severe infections or following organ transplantation."

Statins work in the liver to lower the amount of cholesterol circulating in the blood. They are effective at lowering levels of bad cholesterol (LDL) and blood fats (triglycerides) while raising levels of good cholesterol (HDL), but recent evidence suggests that they also seem to affect the body's inflammatory response.

Inflammation is the second of four phases in normal wound healing. If statins were found to promote inflammation then they could benefit "a significant number of cardiac surgical patients whose wounds heal slowly due to their underlying co-morbidities."

Healing process 'reduced by 5 days'

For their systematic review, the authors studied existing literature and found 20 studies that were deemed eligible for inclusion within their review. Most of those examined featured laboratory-based studies involving animals.

The review suggested that statins did affect the inflammatory response, and on average reduced the wound healing process following surgery from 18.7 days to 13 days. Statin utilization also had the potential of resulting in smaller scars for recovering patients.

The authors identified specific wounds from cardiovascular surgery that could potentially benefit from statin therapy. These included chest wounds from sternotomies, leg wounds from long saphenous veins harvesting and arm wounds from radial artery harvesting. The potential benefits of statin therapy, however, could extend to all kinds of surgical wound.

Fitzmaurice acknowledges that their systematic review raises questions rather than providing answers, opening the door to further research:

Normal wound healing involves a series of phases that ultimately leads to a scar. Many things can affect this process and it's difficult to determine exactly how statins might improve wound healing, but it would appear that they influence a number of factors in the inflammatory response. Our analysis also shows that some statins are better at it than others."

Human trials to follow?

A major limitation with the review is the scarcity of human trials within the literature that was examined. The majority of studies that the team looked at involved laboratory-based animal research.

This is acknowledged by the authors, who suggest that there is enough evidence to merit "an appropriately conducted randomized-controlled double-blind clinical trial," and that "patients already taking a systemic statin should ideally comprise the initial assessment group."

Statins have also been found to have some potentially serious side effects. While for most people statins cause no further health problems, in some cases they can lead to liver damage, muscle problems, diabetes and potential neurological side effects.

The risk of side effects would not be good for patients already-existing underlying co-morbidities. However, the overall results of the review were enough that the authors "anticipate that statins could provide a valuable adjunct to surgeons in the augmentation of wound healing," and that the completion of a full human trial could yield answers to the questions raised by their study.

Previously, womenhealthsecret.com reported on a study examining why statins increase the risk of diabetes, as well as offering a solution to this problem.


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Section Issues On Medicine: Cardiology