Sorg H, Tilkorn DJ, Hager S, Hauser J, Mirastschijski U, et al.
European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europe.... Date of publication 2017 Jan 1;volume 58(1-2):81-94.
1. Eur Surg Res. 2017;58(1-2):81-94. doi: 10.1159/000454919. Epub 2016 Dec 15.
Skin Wound Healing: An Update on the Current Knowledge and Concepts.
Sorg H(1), Tilkorn DJ, Hager S, Hauser J, Mirastschijski U.
Author information:
(1)Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery,
Alfried Krupp Krankenhaus Essen, Essen, Germany.
BACKGROUND: The integrity of healthy skin plays a crucial role in maintaining
physiological homeostasis of the human body. The skin is the largest organ system
of the body. As such, it plays pivotal roles in the protection against mechanical
forces and infections, fluid imbalance, and thermal dysregulation. At the same
time, it allows for flexibility to enable joint function in some areas of the
body and more rigid fixation to hinder shifting of the palm or foot sole. Many
instances lead to inadequate wound healing which necessitates medical
intervention. Chronic conditions such as diabetes mellitus or peripheral vascular
disease can lead to impaired wound healing. Acute trauma such as degloving or
large-scale thermal injuries are followed by a loss of skin organ function
rendering the organism vulnerable to infections, thermal dysregulation, and fluid
loss.
METHODS: For this update article, we have reviewed the actual literature on skin
wound healing purposes focusing on the main phases of wound healing, i.e.,
inflammation, proliferation, epithelialization, angiogenesis, remodeling, and
scarring.
RESULTS: The reader will get briefed on new insights and up-to-date concepts in
skin wound healing. The macrophage as a key player in the inflammatory phase will
be highlighted. During the epithelialization process, we will present the
different concepts of how the wound will get closed, e.g., leapfrogging,
lamellipodial crawling, shuffling, and the stem cell niche. The
neovascularization represents an essential component in wound healing due to its
fundamental impact from the very beginning after skin injury until the end of the
wound remodeling. Here, the distinct pattern of the neovascularization process
and the special new functions of the pericyte will be underscored. At the end,
this update will present 3 topics of high interest in skin wound healing issues,
dealing with scarring, tissue engineering, and plasma application.
CONCLUSION: Although wound healing mechanisms and specific cell functions in
wound repair have been delineated in part, many underlying pathophysiological
processes are still unknown. The purpose of the following update on skin wound
healing is to focus on the different phases and to brief the reader on the
current knowledge and new insights. Skin wound healing is a complex process,
which is dependent on many cell types and mediators interacting in a highly
sophisticated temporal sequence. Although some interactions during the healing
process are crucial, redundancy is high and other cells or mediators can adopt
functions or signaling without major complications.
© 2016 S. Karger AG, Basel.
DOI: 10.1159/000454919
PMID: 27974711 [Indexed for MEDLINE]
