title: Maturation of the human scar: an observational study.
abstract: BACKGROUND
  The natural history of scar maturation in humans has never been formally described from either a clinical or a histologic standpoint.
  
  
  METHODS
  The maturation of incisional scars was observed in 58 healthy male volunteers who each had 2 x 1-cm incisional wounds created on the inner aspect of both upper arms. The resulting scars were photographed digitally at monthly intervals for 12 months and excised for histologic analysis at specific time points. All histologic specimens were stained using Masson's trichrome and reviewed together with the corresponding digital clinical scar images to produce macroscopic and microscopic descriptions of the maturation process.
  
  
  RESULTS
  Three distinct groups, each displaying a different rate of longitudinal progression of scar maturation, were identified from within the study group. The majority of volunteers belonged to a "representative" subset but distinct "poor" and "excellent" subsets were also identified. The poor subset invariably contained volunteers younger than 30 years of age, whereas the majority of the excellent subset comprised subjects older than 55 years of age.
  
  
  CONCLUSIONS
  Scar maturation occurs as a series of defined macroscopic and microscopic stages over the course of 1 year. The rate of scar maturation varied within the study group, with older subjects (>55 years) displaying accelerated maturation, whereas a prolonged high turnover state and a retarded rate of maturation were observed in younger subjects (<30 years).
authors.affiliation: Manchester, United Kingdom From the University of Manchester and Renovo, Ltd.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Bond
authors.forename: Jonathan A L
authors.initials: JAL
authors.lastname: Duncan
authors.forename: Abdul
authors.initials: A
authors.lastname: Sattar
authors.forename: Adam
authors.initials: A
authors.lastname: Boanas
authors.forename: Tracey
authors.initials: T
authors.lastname: Mason
authors.forename: Sharon
authors.initials: S
authors.lastname: O'Kane
authors.forename: Mark W J
authors.initials: MWJ
authors.lastname: Ferguson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002921:Cicatrix / Q000473:pathology* / Q000601:surgery; D062109:Dermatologic Surgical Procedures; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D011183:Postoperative Complications / Q000473:pathology; D012867:Skin / Q000473:pathology; D014945:Wound Healing / Q000502:physiology*