Cutaneous Response to Injury and Wound Healing

Edel A. O'Toole


Wound healing is a complex and dynamic response to injury that can be divided into three phases: inflammation, re‐epithelialization and matrix remodelling. Interactions are required between keratinocytes, fibroblasts, endothelial and inflammatory cells, growth factors, extracellular matrix and enzymes called proteases. Fetal wounds can heal without scarring; however wounds in children and adults heal with a remodelling phase resulting in a scar. Non‐healing or chronic wounds occur because of infection or pressure as well as systemic factors such as ischaemia or diabetes. Abnormal scarring results in hypertrophic or keloid scars. The effect of secreted heat shock proteins, regulation by microRNAs, manipulation of macrophage polarization and wound treatment with mesenchymal stem cells (by direct application or mobilization from bone marrow) are new areas of interest.
Keywords keratinocyte migration, extracellular matrix, angiogenesis, scarring, chronic wounds, diabetic wounds, keloid scars, mesenchymal stem cells, skin substitutes, growth factors


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