This review article, authored by J.M. Reinke and H. Sorg from the Department of Plastic, Hand, and Reconstructive Surgery at Hannover Medical School, Germany, focuses on the healing processes of skin wounds, particularly the classical phases of wound healing. The skin, being the largest organ of the human body, undergoes a unique and complex healing mechanism that involves multiple cellular, humoral, and molecular interactions. The article highlights the differences between regeneration, which involves the specific substitution of tissues like the epidermis or mucosa, and repair, which is an unspecific form of healing characterized by fibrosis and scar formation.
The review begins by discussing the initial stages of wound healing, including hemostasis and the formation of a provisional wound matrix, which occur immediately after injury. This phase also initiates the inflammatory response, involving neutrophil recruitment and the activation of monocytes. The proliferation phase, which typically lasts from 3 to 10 days, focuses on reepithelialization, neovascularization, and the formation of granulation tissue. Key processes include the migration of keratinocytes and fibroblasts, the activation of angiogenesis, and the synthesis of collagen and other extracellular matrix components.
The remodeling phase, which can last up to a year, involves the maturation of granulation tissue and the formation of a scar. This phase is marked by the replacement of the provisional wound matrix with a more stable connective tissue, characterized by changes in the extracellular matrix and the resolution of inflammation.
The article also discusses the unique healing process in fetal wounds, which exhibit scarless healing due to differences in the extracellular matrix, inflammatory response, and gene expression. Finally, the review explores the role of inflammation in scar formation, noting that excessive inflammation can lead to hypertrophic or keloid scars. The conclusion emphasizes the complexity of wound healing and the potential for new therapies to improve healing outcomes, particularly in chronic or non-healing wounds.This review article, authored by J.M. Reinke and H. Sorg from the Department of Plastic, Hand, and Reconstructive Surgery at Hannover Medical School, Germany, focuses on the healing processes of skin wounds, particularly the classical phases of wound healing. The skin, being the largest organ of the human body, undergoes a unique and complex healing mechanism that involves multiple cellular, humoral, and molecular interactions. The article highlights the differences between regeneration, which involves the specific substitution of tissues like the epidermis or mucosa, and repair, which is an unspecific form of healing characterized by fibrosis and scar formation.
The review begins by discussing the initial stages of wound healing, including hemostasis and the formation of a provisional wound matrix, which occur immediately after injury. This phase also initiates the inflammatory response, involving neutrophil recruitment and the activation of monocytes. The proliferation phase, which typically lasts from 3 to 10 days, focuses on reepithelialization, neovascularization, and the formation of granulation tissue. Key processes include the migration of keratinocytes and fibroblasts, the activation of angiogenesis, and the synthesis of collagen and other extracellular matrix components.
The remodeling phase, which can last up to a year, involves the maturation of granulation tissue and the formation of a scar. This phase is marked by the replacement of the provisional wound matrix with a more stable connective tissue, characterized by changes in the extracellular matrix and the resolution of inflammation.
The article also discusses the unique healing process in fetal wounds, which exhibit scarless healing due to differences in the extracellular matrix, inflammatory response, and gene expression. Finally, the review explores the role of inflammation in scar formation, noting that excessive inflammation can lead to hypertrophic or keloid scars. The conclusion emphasizes the complexity of wound healing and the potential for new therapies to improve healing outcomes, particularly in chronic or non-healing wounds.