Scar and contracture: biological principles.
Dysregulated wound healing and pathologic fibrosis cause abnormal scarring, leading to poor functional and aesthetic results in hand burns. Understanding the underlying biologic mechanisms involved allows the hand surgeon to better address these issues, and suggests new avenues of research to improve patient outcomes. In this article, the authors review the biology of scar and contracture by focusing on potential causes of abnormal wound healing, including depth of injury, cytokines, cells, the immune system, and extracellular matrix, and explore therapeutic measures designed to target the various biologic causes of poor scar.
Kwan
Peter
P
Division of Plastic and Reconstructive Surgery, Department of Surgery, 2D2.28 WMC, University of Alberta, 8440-112 Street, Edmonton, AB T6G 2B7, Canada.
Hori
Keijiro
K
Ding
Jie
J
Tredget
Edward E
EE
D000818:Animals; D002921:Cicatrix / Q000503:physiopathology*; D003286:Contracture / Q000503:physiopathology*; D016207:Cytokines / Q000502:physiology; D005347:Fibroblasts / Q000502:physiology; D006801:Humans; D015603:Keratinocytes / Q000502:physiology; D010982:Platelet-Derived Growth Factor / Q000502:physiology; D013165:Splints; D013601:T-Lymphocytes / Q000502:physiology; D016212:Transforming Growth Factor beta / Q000502:physiology; D014945:Wound Healing / Q000502:physiology*
D016207:Cytokines; D010982:Platelet-Derived Growth Factor; D016212:Transforming Growth Factor beta