Abstract
A continuum hypothesis-based model is presented for the simulation of the formation and the subsequent regression of hypertrophic scar tissue after dermal wounding. Solely the dermal layer of the skin is modeled explicitly and it is modeled as a heterogeneous, isotropic and compressible neo-Hookean solid. With respect to the constituents of the dermal layer, the following components are selected as primary model components: fibroblasts, myofibroblasts, a generic signaling molecule and collagen molecules. A good match with respect to the evolution of the thickness of the dermal layer of scars between the outcomes of simulations and clinical measurements on hypertrophic scars at different time points after injury in human subjects is demonstrated. Interestingly, the comparison between the outcomes of the simulations and the clinical measurements demonstrates that a relatively high apoptosis rate of myofibroblasts results in scar tissue that behaves more like normal scar tissue with respect to the evolution of the thickness of the tissue over time, while a relatively low apoptosis rate results in scar tissue that behaves like hypertrophic scar tissue with respect to the evolution of the thickness of the tissue over time. Our ultimate goal is to construct models with which the properties of newly generated tissues that form during wound healing can be predicted with a high degree of certainty. The development of the presented model is considered by us as a step toward their construction.
Highlights
The skin is an important, multifunctional organ; it plays a crucial role in maintaining homeostasis and acts as a protective physical barrier to potentially damaging environmental factors such as pathogens, oxidative stresses and applied mechanical forces (O’Toole and Mellerio 2010)
In the case of deep dermal wounds, the final outcome of the execution of these processes is usually a thin, flat scar when the restoration of the wounded area proceeds without complications (Hawkins and Finnerty 2012; Verhaegen et al 2009). The restoration of these deep dermal wounds gets perturbed during the initial period postwounding, and this might cause the growing, newly generated tissue to evolve into hypertrophic scar tissue (Hawkins and Finnerty 2012; Niessen et al 1999)
In order to simulate the formation and the subsequent regression of hypertrophic scar tissue, we incorporate into the model some of the processes that take place during the proliferative and the remodeling phase of the wound healing cascade
Summary
The skin is an important, multifunctional organ; it plays a crucial role in maintaining homeostasis and acts as a protective physical barrier to potentially damaging environmental factors such as pathogens, oxidative stresses and applied mechanical forces (O’Toole and Mellerio 2010). The restoration of these deep dermal wounds gets perturbed during the initial period postwounding, and this might cause the growing, newly generated tissue to evolve into hypertrophic scar tissue (Hawkins and Finnerty 2012; Niessen et al 1999). 2 a general overview of the main processes that bring about the formation of normal scar tissue during the healing of deep dermal wounds that cover a large surface area. This overview serves as the biomedical basis for the development of the model.
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