Process of Scar Healing

New Scar Cure Innovations: Regeneration, Contraction & Scar Tissue

Three processes contribute to the healing outcome of a trauma, wound or injury caused by trauma, an accident or from undergoing plastic or reconstructive surgery: contraction, scar formation and regeneration. Of these three processes, contraction (rather than scar formation) is the clearly principal factor for spontaneous wound healing in adults.

In contrast skin wounds on early mammalian embryos heal perfectly with not a single sign of scarring and full restitution of the normal skin tissues.

Regeneration.
Limb regeneration in certain amphibians is a spectacular feat by which an amputated limb grows back to its original form, recovering its normal function. It's the prototypical paradigm of regeneration. Very few adult amphibians, and none of the adult mammals, can replicate this feat. Instead, almost all mammals, including adult humans, respond to severe injury by a spontaneous healing process.

Repair means that the wound is closed by contraction and synthesis of scar tissue without recovery of the uninjured tissues. In contrast, regeneration closes the wound recreating the missing organ (skin is an organ) at the original site, yielding a regenerate. Regeneration restores the normal structure and function of the organ; repair does not.

Wounds in early mammalian embryos heal without scar formation.
Unlike the adult, the mammalian foetus heals its wounds spontaneously by regeneration with negligible contraction, no scar formation, diminished inflammatory response and increased levels of hyaluronic acid (hyaluronan, HA) synthesis, provided that the injury has been inflicted at a sufficiently early stage of gestation, usually before the 3º trimester.

A developmental transition, occurring during late mammalian gestation, leads from healing primarily by regeneration to healing by repair. During this stage closure of the damaged site by regeneration is mainly replaced by closure based on contraction and scar formation.

It is also a fact that scarring use to be worse in children and teenagers, due to their enhanced inflammatory reaction, whilst the quality of scarring in elderly people is often better, as a result of an altered inflammatory and immune reaction at the wound site.

To understand the mechanisms underlying scar-free wound healing, researchers lead by Dr Mark Ferguson, D.D.S., Ph.D., professor in the faculty of life sciences at the University of Manchester, England have studied the differences in cellular and molecular responses to injuries in embryonic and adult injuries healing models.

Scar formation
To restore the barrier function of the skin as soon as possible, closure of skin wounds and replacement of missing skin tissue occur rapidly in adult skin by a mechanism that leads to scarring.

The transition from scar free embryonic wound healing to scar-forming adult wound healing is a gradual one and is characterized by the abnormal organization of the neo-dermis, predominantly the abnormal deposition of small parallel bundles of extracellular matrix between the margins of the wound (consisting largely of collagen types I and III and fibronectin) to form the scarring as opposed to the deposition of large bundles of extracellular matrix in a normal basketweave orientation in the normal skin and in the neo-dermis of an embryonic wound. Scarring is therefore a morphogenetic problem, i.e. an error in the regeneration of the normal skin structure as opposed to a biochemical problem, e.g. abnormal composition of the scar tissue.

Modern research has shed light on the scarring process, and how to use this knowledge for developing new alternatives for Scar Treatment.

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