Abstract
Skin wound healing is a vital process that is important for re-establishing the epithelial barrier following disease or injury. Aberrant or delayed skin wound healing increases the risk of infection, causes patient morbidity, and may lead to the formation of scar tissue. One of the most important events in wound healing is coverage of the wound with a new epithelial layer. This occurs when keratinocytes at the wound periphery divide and migrate to re-populate the wound bed. Many approaches are under investigation to promote and expedite this process, including the topical application of growth factors and the addition of autologous and allogeneic tissue or cell grafts. The mechanical environment of the wound site is also of fundamental importance for the rate and quality of wound healing. It is known that mechanical stress can influence wound healing by affecting the behaviour of cells within the dermis, but it remains unclear how mechanical forces affect the healing epidermis. Tensile forces are known to affect the behaviour of cells within epithelia, however, and the material properties of extracellular matrices, such as substrate stiffness, have been shown to affect the morphology, proliferation, differentiation and migration of many different cell types. In this review we will introduce the structure of the skin and the process of wound healing. We will then discuss the evidence for the effect of tissue mechanics in re-epithelialisation and, in particular, on stem cell behaviour in the wound microenvironment and in intact skin. We will discuss how the elasticity, mechanical heterogeneity and topography of the wound extracellular matrix impact the rate and quality of wound healing, and how we may exploit this knowledge to expedite wound healing and mitigate scarring.
Highlights
Skin wound healing is a vital process that is important for re-establishing the epithelial barrier following disease or injury
Since keratinocytes are mechanosensitive cells that are intrinsically involved with the process of wound healing, one may ask an obvious question: what is the mechanical environment of the healing wound and how does this affect and/or signal to the keratinocyte and epidermal cells which must act to close the wound?
Skin homeostasis and wound healing is intrinsically linked to the mechanical properties of the epithelium of the skin
Summary
The skin is the largest organ in the body. It fulfils a variety of functions, most importantly as a barrier separating the internal organs of the body and the external environment. The skin of the palms of the hands and the soles of the feet in humans is clearly distinguished from that of the trunk or scalp The latter is characterised by the presence of hair follicles while the former is characterised by the absence of hair follicles and by patterns of bifurcated rete ridges which project deep into the dermis. Inflammatory cells are recruited to the wound site by a variety of chemotactic signals and engulf foreign particles, including bacteria As this process progresses, fibroblastic cells are attracted to the wound bed and begin to secrete collagenous ECM known as granulation tissue, which gradually replaces the fibrin eschar (scab). Scars may become hypertrophic leading to tissue contracture, making it difficult for affected patients to move joints in nearby affected areas (Tredget et al, 1997)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of the Mechanical Behavior of Biomedical Materials
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
