Clinical Management of Wound Healing and Hypertrophic Scarring

In health, wound healing in adult humans results in the deposition of fibrotic tissue, known as scar. This process is similar throughout the body, and when it occurs in tissues such as the heart, lung, or liver, it can result in end-organ dysfunction. When normal homeostatic mechanisms fail and dysfunctional wound healing prevails, the result can range from nonhealing ulcers requiring amputation to large debilitating scars. This chapter provides an overview of the cellular and molecular processes underlying cutaneous wound healing. Mechanisms involved in dysfunctional wound healing are highlighted, ranging from nonhealing ulcers to fibroproliferative disease. Current therapies for dysfunctional healing are discussed, with an emphasis on emerging therapeutic concepts and opportunities for further research.