Abstract

Fibrosis is intimately linked to wound healing and is one of the largest causes of wound-related morbidity. While scar formation is the normal and inevitable outcome of adult mammalian cutaneous wound healing, scarring varies widely between different anatomical sites. The spectrum of craniofacial wound healing spans a particularly diverse range of outcomes. While most craniofacial wounds heal by scarring, which can be functionally and aesthetically devastating, healing of the oral mucosa represents a rare example of nearly scarless postnatal healing in humans. In this review, we describe the typical wound healing process in both skin and the oral cavity. We present clinical correlates and current therapies and discuss the current state of research into mechanisms of scarless healing, toward the ultimate goal of achieving scarless adult skin healing.

Highlights

  • The Spectrum of Scarring in Craniofacial Wound RepairHeather E. desJardins-Park, Shamik Mascharak, Malini S

  • Wound healing is a complex molecular process whose fundamental steps are conserved among all organ systems in the human body

  • The present review will discuss wound healing and fibrosis in the craniofacial setting, with particular emphasis on comparing skin healing to healing of the oral mucosa

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Summary

The Spectrum of Scarring in Craniofacial Wound Repair

Heather E. desJardins-Park, Shamik Mascharak, Malini S. Specialty section: This article was submitted to Craniofacial Biology and Dental. Fibrosis is intimately linked to wound healing and is one of the largest causes of wound-related morbidity. While scar formation is the normal and inevitable outcome of adult mammalian cutaneous wound healing, scarring varies widely between different anatomical sites. The spectrum of craniofacial wound healing spans a diverse range of outcomes. While most craniofacial wounds heal by scarring, which can be functionally and aesthetically devastating, healing of the oral mucosa represents a rare example of nearly scarless postnatal healing in humans. We describe the typical wound healing process in both skin and the oral cavity. We present clinical correlates and current therapies and discuss the current state of research into mechanisms of scarless healing, toward the ultimate goal of achieving scarless adult skin healing

INTRODUCTION
OVERVIEW OF THE WOUND HEALING PROCESS
Adult Skin Wounds Heal by Scarring
The Burden of Craniofacial Scarring
Factors Influencing Scarring
WOUND HEALING OF THE ORAL MUCOSA
Role of Environment in Scarless Oral Healing
Reduced Inflammation in Oral Healing
Differences in Angiogenesis
Complicated Wound Healing in the Oral Cavity
CURRENT THERAPIES FOR SCARRING
Fibroblast Heterogeneity and Scarring
Molecular Signature of Wound Healing
Models of Scarless Healing
Epithelial Cell Differences
Toward Novel Therapeutics
Findings
CONCLUSION
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