WOUND HEALING: AN OVERVIEW OF ACUTE, FIBROTIC AND DELAYED HEALING

WOUND HEALING: AN OVERVIEW OF ACUTE, FIBROTIC AND DELAYED HEALING

January 1, 2004 | Robert F. Diegelmann 1, and Melissa C. Evans 2
The article provides an overview of wound healing, focusing on acute, fibrotic, and delayed healing processes. Acute wounds heal through four distinct phases: hemostasis, inflammation, proliferation, and remodeling. Each phase is characterized by specific biological markers and cell types, such as platelets, neutrophils, macrophages, and fibroblasts. The inflammatory phase involves the release of growth factors and cytokines, which recruit and activate these cells to remove foreign materials and damaged tissue. The proliferative phase is marked by the production of new extracellular matrix, primarily collagen, by fibroblasts. The remodeling phase involves the cross-linking and organization of collagen to restore normal tissue structure and function. In contrast, pathological conditions like fibrosis and chronic non-healing ulcers disrupt this orderly process. Fibrosis is characterized by excessive matrix deposition and reduced remodeling, often associated with increased mast cell density. Chronic non-healing ulcers, such as pressure ulcers, are marked by chronic inflammation, excessive neutrophil infiltration, and the release of destructive enzymes. Understanding these normal and pathological processes can help develop new strategies for treating these conditions. The article also discusses the role of various cytokines and growth factors in wound healing, the importance of cell signaling, and the significance of collagen in both normal and fibrotic tissues.The article provides an overview of wound healing, focusing on acute, fibrotic, and delayed healing processes. Acute wounds heal through four distinct phases: hemostasis, inflammation, proliferation, and remodeling. Each phase is characterized by specific biological markers and cell types, such as platelets, neutrophils, macrophages, and fibroblasts. The inflammatory phase involves the release of growth factors and cytokines, which recruit and activate these cells to remove foreign materials and damaged tissue. The proliferative phase is marked by the production of new extracellular matrix, primarily collagen, by fibroblasts. The remodeling phase involves the cross-linking and organization of collagen to restore normal tissue structure and function. In contrast, pathological conditions like fibrosis and chronic non-healing ulcers disrupt this orderly process. Fibrosis is characterized by excessive matrix deposition and reduced remodeling, often associated with increased mast cell density. Chronic non-healing ulcers, such as pressure ulcers, are marked by chronic inflammation, excessive neutrophil infiltration, and the release of destructive enzymes. Understanding these normal and pathological processes can help develop new strategies for treating these conditions. The article also discusses the role of various cytokines and growth factors in wound healing, the importance of cell signaling, and the significance of collagen in both normal and fibrotic tissues.
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