Skin Acute Wound Healing: A Comprehensive Review

Abstract

Experimental work of the last two decades has revealed the general steps of the wound healing process. This complex network has been organized in three sequential and overlapping steps. The first step of the inflammatory phase is an immediate response to injury; primary sensory neurons sense injury and send danger signals to the brain, to stop bleeding and start inflammation. The following target of the inflammatory phase, led by the peripheral blood mononuclear cells, is to eliminate the pathogens and clean the wound. Once this is completed, the inflammatory phase is resolved and homeostasis is restored. The aim of the proliferative phase, the second phase, is to repair wound damage and begin tissue remodeling. Fibroplasia, reepithelialization, angiogenesis, and peripheral nerve repair are the central actions of this phase. Lastly, the objective of the final phase is to complete tissue remodeling and restore skin integrity. This review provides present day information regarding the status of the participant cells, extracellular matrix, cytokines, chemokines, and growth factors, as well as their interactions with the microenvironment during the wound healing process.

A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection

“…This elicits an inflammatory response that removes any foreign material at the site of injury, significantly reduces the spread of pathogens to other tissues, and prepares the site for tissue repair. The fever that can accompany inflammation intensifies the effects of IFNs, inhibits some microbial growth, and speeds up the body reactions that aid repair [92]. Following injury, vasoconstriction of the capillaries occurs briefly followed by vasodilation, resulting from histamine release from mast cells, basophils, and platelets to increase blood flow and vascular permeability.…”

“…The activated phagocytes release pro-and anti-inflammatory cytokines/chemokines, bradykinin, prostaglandins, leukotrienes, and complement, which keeps capillaries dilated, floods the tissues with fluids, and increases the numbers of neutrophils to fight pathogens. Subsequently, macrophages are recruited to clean up the dead cells and debris and healing occurs [92].…”

A spray containing extracts of oat plantlets and Uncaria tomentosa relieves pain associated with chronic inflammatory skin diseases and dermatological procedures

“…Both inflammatory dermatoses and dermatological procedures expose cutaneous nerve endings, leading to the transmission of pain signals to the central nervous system 4‐6 . Psoriasis and eczema (AD and hand eczema [HE]) are complex, chronic, skin diseases associated with intense itching 7‐10 .…”

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“…A fast healing process in the treated samples was confirmed by the activation of MHC class II+ cells after 6 hours, 6 by an earlier differentiation of macrophages from the M1 pro-inflammatory subtype to the M2 tissue repairing one 8 (Figure 1D), by the activation of myeloid 6 (Figure 2A) and plasmacytoid dendritic cells 9 (Figure 2B), often in contact with Treg cells 10 that were activated also through proliferation within early time points (data not shown), and lastly by the analysis of TNF-alpha and TGF-beta patterns (Figure 2C,D). 7 We can hypothesize that the effect on wounded skin results in a stimulation of mast cell degranulation, which in turn leads to a modulation of cytokines release, such as TNF-alpha and TGF-beta. These effects could induce: (a) a rapid reorganization of the inflammatory infiltrate; (b) a stimulation of the angiogenesis process and in a TNFalpha-mediated fashion; (c) a migration of APC cells such as macrophages or myeloid dendritic cells.…”

“…10 A rapid onset of the inflammatory phase may, therefore, be the leading process underlying a better recovery of superficial wounds after irradiation. 7…”