Examining the association of immunosuppressants and wound healing: a narrative review.

Objective A review of recent literature to provide clinicians with an understanding of how different classes of immunosuppressants affect wound healing. Data sources A literature search was conducted in PubMed, Google Scholar, and the University of Calgary Health Sciences Library. Study Selection Studies chosen for inclusion were screened initially based on title using key words including "immunosuppressive medication, wound healing, and immunosuppression." If the title and/or abstract contained these key words and addressed wound healing related to immunosuppressant medications and had been published after 2000, they were included in the review. When human data was not available for an immunosuppressant (class), animal studies were included. Data Extraction Selected papers underwent full text review and summarisation. Data Synthesis Data were synthesised in a descriptive manner. Corticosteroids and mechanistic target of rapamycin (mTOR) inhibitors most consistently demonstrate detrimental effects on wound healing. For other classes of immunosuppressants, evidence is limited with varying effects on wound healing described. Conclusions Larger high-quality studies are required to better understand the effects of immunosuppressants particularly with development of new classes of these drugs on wound healing in order to identify those at highest risk of impairing wound healing. [ABSTRACT FROM AUTHOR]