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The human body can sustain several kinds of injuries such as burns, cuts, and knocks or bangs. Well, all of these aggressions commence an orderly set of steps that are involved in the healing response, in which the normal healthy tissue (skin) is replaced by connective tissue (scar). The healing response is also characterized by the movement of specialized cells into the injury site.
Healing is the complex and dynamic process that results in the restoration of anatomical continuity and function. There are 4 basic responses that can occur after an injury:
1.Regeneration (exact replacement)
Regeneration happens when there is loss of structure and functionality. Our body is so incredible, that it has the sophisticated capacity to restore that tissue by replacing exactly what was there before the injury. Smaller forms of life, such as the salamander and crab, can regenerate tissue in this manner. As man has evolved, we have lost this capacity and can only recover a limited amount of injured tissues by the process of regeneration.
2. Normal repair (reestablished equilibrium)
Normal repair is the response where there is a re-established equilibrium between scar creation and scar remodeling. This is the typical response that most humans develop after an injury. The pathological response to tissue injury stand in sharp contrast to the normal repair response.
3. Excessive healing (fibrosis and contractures)
In excessive healing there is too much accumulation of connective tissue; this produces an altered tissue and, thus, loss of functionality. Fibrosis, structures, adhesions and contractures are examples of excessive healing. Keloids and hypertrophic scars in the skin are examples of fibrosis. Contraction is part of the normal process of healing but if excessive, it becomes pathologic and is known as a contracture.
4. Deficient healing (chronic ulcers)
Deficient healing is the opposite of fibrosis; it appears when there is insufficient deposition of connective tissue matrix and the tissue is thinned to the point where it can fall apart. Chronic uncurable ulcers are examples of deficient healing.
The Skin’s Natural Regenerative Process
Just as an injury occurs, several different cells are sent to the damaged site, and the complex healing process begins.
The normal healing cascade commences with an orderly process of hemostasis and fibrin accumulation, which leads to an inflammatory cell cascade, characterized by neutrophils, macrophages and lymphocytes within the tissue. This is followed by migration and proliferation of fibroblasts and collagen accumulation, and finally remodeling by collagen cross-linking and scar maturation. Despite this orderly sequence of steps responsible for normal wound repairing, abnormal responses leading to fibrosis or chronic ulcers may happen if any part of the healing sequence is altered.
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- Abigail Mckenzee
