title: A Paradigm of Fibroblast Activation and Dermal Wound Contraction to Guide the Development of Therapies for Chronic Wounds and Pathologic Scars.
abstract: CONCLUSIONS
  Delayed wound healing and pathologic scarring are abnormal processes that can be thought of as occurring on a wound healing continuum, where insufficient wound contraction leads to nonhealing wounds, and overexuberant wound contraction leads to scarring. Chronic nonhealing wounds, including diabetic foot wounds, decubitus ulcers, and venous stasis ulcers, affect millions of people annually in the United States and costs billions of dollars. Similarly, pathologic scaring affects more than 40 million Americans annually and also costs billions of dollars.
  
  
  RESULTS
  While there are multiple factors that contribute to chronic nonhealing wounds and pathologic scars, a derangement in wound contraction is common to both. In this article, we will present a paradigm of dermal wound contraction, derived from clinical observations and basic science evidence, which pertains to chronic nonhealing wounds and pathologic scars.
  
  
  BACKGROUND
  We will review how select therapies currently under investigation and in development fit the paradigm.
  
  
  CONCLUSIONS
  The paradigm will facilitate translational research and enable the development of future innovative therapies.
authors: Division of Plastic and Reconstructive Surgery, Department of Surgery; Department of Pathology; Duke University Medical Center , Durham, North Carolina.
authors: Howard
authors: H
authors: Levinson