Chronic exposure to aluminum (Al) from injectables can cause significant clinical problems, including neurological, bone, and liver diseases. These adverse effects are most likely to occur in individuals receiving long-term intravenous therapy, such as home total parenteral nutrition (TPN) patients, but can also occur in premature infants and neonates over relatively short-term but continuous periods of exposure. Of the types of intravenous infusions containing substantial amounts of aluminum, parenteral nutrition admixtures are notable sources for this contaminant.

• Inflammation begins at the time of injury and continues for 4 to 6 days. Macrophages migrate to the wound, remove the necrotic tissue and bacteria, and secrete growth factors.^2,3 Bleeding is controlled.
• Proliferation begins on the third or fourth day after injury and continues for 2 weeks. Fibroblasts and epithelial cells proliferate. Collagen synthesis, deposition, and cross-linking provide integrity and strength to the wound. Epithelialization occurs within 5 to 15 days, depending on the size and depth of the wound.²
• Maturation begins in the second or third week after injury and may continue for up to 2 years. Collagen stabilization, which increases the tensile strength of the wound, occurs throughout this phase, and fibroblasts decrease in number.^2,4