Predictive role of MMP-2 and MMP-9 in wound healing outcomes among critically ill patients: An observational study

Background: Inflammation and wound healing are significantly influenced by matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). TIMPs control the breakdown of extracellular matrix components, whereas MMPs promote it, which is necessary for tissue remodeling. In critically ill surgical patients, proper wound healing is a major concern due to complications that can impair recovery. This study aims to evaluate the potential of MMP2, MMP9, TIMP2, and TIMP9 as biomarkers for wound healing, providing insights into their roles in the recovery of seriously ill surgical patients. Materials and Methods: The present study, conducted at Deccan College of Medical Sciences, Hyderabad, from January 2021 to June 2022, involved 50 critically ill surgical patients. After ethics approval, data on demographics, clinical status, and postoperative outcomes were collected. Serum levels of MMP2, MMP9, TIMP2, and TIMP9 were measured by enzyme-linked immunosorbent assay, and routine hematological tests along with the Southampton grading system were used for evaluation. Results: In this study, MMP2 levels varied significantly with APACHE II ( P = 0.017) and SOFA scores ( P = 0.046) and were higher in survivors ( P = 0.058), indicating potential prognostic value. MMP2 showed negative correlations with PCT ( P = 0.055) and C-reactive protein ( P = 0.059) and a positive correlation with TLC ( P = 0.301). MMP9 correlated positively with interleukin 1 ( P = 0.00025) and TIMP ( P = 0.067), and negatively with PCT ( P = 0.055) and C-reactive protein ( P = 0.059), but did not differ significantly by outcome ( P = 0.908). Conclusions: The study suggests that MMP-2, but not MMP-9, may be a useful predictor of wound healing in critically ill patients. MMP-2 levels showed significant associations with APACHE II and SOFA scores and were lower in nonsurvivors, indicating prognostic value. MMP-9 showed no significant associations, highlighting MMP-2 as the more reliable marker.