Cutaneous Wound Healing: An Update from Physiopathology to Current Therapies

Lucas Fernando Sérgio Gushiken, Fernando Pereira Beserra, Jairo Kenupp Bastos, Christopher John Jackson, Cláudia Helena Pellizzon, Lucas Fernando Sérgio Gushiken, Fernando Pereira Beserra, Jairo Kenupp Bastos, Christopher John Jackson, Cláudia Helena Pellizzon

Abstract

The skin is the biggest organ of human body which acts as a protective barrier against deleterious agents. When this barrier is damaged, the organism promotes the healing process with several molecular and cellular mechanisms, in order to restore the physiological structure of the skin. The physiological control of wound healing depends on the correct balance among its different mechanisms. Any disruption in the balance of these mechanisms can lead to problems and delay in wound healing. The impairment of wound healing is linked to underlying factors as well as aging, nutrition, hypoxia, stress, infections, drugs, genetics, and chronic diseases. Over the years, numerous studies have been conducted to discover the correct approach and best therapies for wound healing, including surgical procedures and non-surgical treatments such as topical formulations, dressings, or skin substitutes. Thus, this general approach is necessary to facilitate the direction of further studies. This work provides updated concepts of physiological mechanisms, the factors that can interfere, and updated treatments used in skin wound healing.

Keywords: dressings; skin; skin substitutes; topical formulation; wound healing; wound therapies.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Phases of physiological wound healing. Inflammatory phase: there is the hemostasis of wounded area and acute inflammation through the release of cytokines, growth factors and the migration of leukocytes in the area. Proliferative phase: increase in the migration and proliferation of the keratinocytes, fibroblasts, endothelial cells and leukocytes in the wound. Increase in the synthesis of extracellular matrix components and improve of angiogenesis and re-epithelialization mechanisms. Remodeling phase: extracellular matrix remodeling, with substitution of collagen III for collagen I. Increase in the activity of MMPs. Apoptosis of provisional endothelial cells, fibroblasts, and myofibroblasts of the injury.
Figure 2
Figure 2
Factors that affect wound healing. Common situations that delay skin wound healing.

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Source: PubMed

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