RT Book, Section A1 Hamm, Rose A1 Carey, Joseph N. SR Print(0) ID 1179739293 T1 Immune-Mediated Tissue Injury T2 Essential Elements of Wound Diagnosis YR 2021 FD 2021 PB McGraw Hill PP New York, NY SN 9781260460476 LK accessphysiotherapy.mhmedical.com/content.aspx?aid=1179739293 RD 2024/03/28 AB The goal of the immune system is to protect the body from anything that is not a part of it, from germs to foreign bodies to harmful substances. The exquisite process of immunology begins in the skin with cells that phagocytose bacteria (macrophages, polymorphic neutrophilic lymphocytes), cells that release cytokines (endothelial cells, activated platelets, neutrophils, and T-lymphocytes), and dendritic cells that carry antigens from the injury site to the local lymph nodes where the adaptive immune system is activated.1 If the immune system is over-activated, the body will attack itself and destroy healthy cells and tissues; if it is suppressed, the body becomes susceptible to microbes that are normally destroyed and therefore it develops infections more easily.2 While a discussion of this miraculous process is beyond the scope of this chapter, it is important to recognize that both the up- and down-regulation of the immune system and its processes can result in dermal wounds, or they can impede the healing of existing wounds through a change in cellular activity or as a result of the medication used to treat the disorder. The purpose of this chapter is to assist the clinician in recognizing wounds that are mediated by immune disorders, as well as to stress the importance of understanding the effects of medications (e.g. corticosteroids, NSAIDs, anti-rejection medications, and other immune-suppressors) on the wound healing process, in which case collaboration between the wound care clinician and the immunologist is needed to manage the medications in such a way that wound healing is optimized.