Connections Among Biologic Embedding of Childhood Adversity, Adult Chronic Illness, and Wound Care: A Review of the Literature

Adverse childhood experiences (ACEs) biologically embed by altering brain development and influencing epigenetic mechanisms. These experiences may generate health risk factors. Purpose: A literature review was conducted to compare ACE-generated health risk factors with risk factors for wound development and aberrant healing, as well as to identify a gap in literature regarding critical connections between ACEs, chronic illness, and wound development/healing, with associated practice implications. Methodology: A literature search of English-language articles was conducted using the Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and PubMed using the search terms adverse childhood experiences, adults, wounds, chronic disease or illness, and epigenetics. The searches yielded 561 publications regarding ACEs, chronic illness or disease, and adult; 182 for ACEs; and 547 for epigenetics and wounds. Abstracts were reviewed to remove duplicates and studies with participants who were