title: Scarless wound healing: chasing the holy grail.
abstract: Over 100 million patients acquire scars in the industrialized world each year, primarily as a result of elective operations. Although undefined, the global incidence of scarring is even larger, extending to significant numbers of burn and other trauma-related wounds. Scars have the potential to exert a profound psychological and physical impact on the individual. Beyond aesthetic considerations and potential disfigurement, scarring can result in restriction of movement and reduced quality of life. The formation of a scar following skin injury is a consequence of wound healing occurring through reparative rather than regenerative mechanisms. In this article, the authors review the basic stages of wound healing; differences between adult and fetal wound healing; various mechanical, genetic, and pharmacologic strategies to reduce scarring; and the biology of skin stem/progenitor cells that may hold the key to scarless regeneration.
authors.affiliation: Stanford, Calif.; and Baltimore, Md. From the Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Plastic and Reconstructive Surgery, and the Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine; and the Department of Surgery, Division of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine.
authors.forename: Graham G
authors.initials: GG
authors.lastname: Walmsley
authors.forename: Zeshaan N
authors.initials: ZN
authors.lastname: Maan
authors.forename: Victor W
authors.initials: VW
authors.lastname: Wong
authors.forename: Dominik
authors.initials: D
authors.lastname: Duscher
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hu
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Zielins
authors.forename: Taylor
authors.initials: T
authors.lastname: Wearda
authors.forename: Ethan
authors.initials: E
authors.lastname: Muhonen
authors.forename: Adrian
authors.initials: A
authors.lastname: McArdle
authors.forename: Ruth
authors.initials: R
authors.lastname: Tevlin
authors.forename: David A
authors.initials: DA
authors.lastname: Atashroo
authors.forename: Kshemendra
authors.initials: K
authors.lastname: Senarath-Yapa
authors.forename: H Peter
authors.initials: HP
authors.lastname: Lorenz
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Gurtner
authors.forename: Michael T
authors.initials: MT
authors.lastname: Longaker
mesh_terms: D002921:Cicatrix / Q000503:physiopathology*; D006801:Humans; D012038:Regeneration / Q000502:physiology*; D012867:Skin / Q000503:physiopathology*; D012879:Skin Physiological Phenomena; D014945:Wound Healing / Q000502:physiology*