Skin Wound Healing: An Update on the Current Knowledge and Concepts

Abstract

Background: The integrity of healthy skin plays a crucial role in maintaining physiological homeostasis of the human body. The skin is the largest organ system of the body. As such, it plays pivotal roles in the protection against mechanical forces and infections, fluid imbalance, and thermal dysregulation. At the same time, it allows for flexibility to enable joint function in some areas of the body and more rigid fixation to hinder shifting of the palm or foot sole. Many instances lead to inadequate wound healing which necessitates medical intervention. Chronic conditions such as diabetes mellitus or peripheral vascular disease can lead to impaired wound healing. Acute trauma such as degloving or large-scale thermal injuries are followed by a loss of skin organ function rendering the organism vulnerable to infections, thermal dysregulation, and fluid loss. Methods: For this update article, we have reviewed the actual literature on skin wound healing purposes focusing on the main phases of wound healing, i.e., inflammation, proliferation, epithelialization, angiogenesis, remodeling, and scarring. Results: The reader will get briefed on new insights and up-to-date concepts in skin wound healing. The macrophage as a key player in the inflammatory phase will be highlighted. During the epithelialization process, we will present the different concepts of how the wound will get closed, e.g., leapfrogging, lamellipodial crawling, shuffling, and the stem cell niche. The neovascularization represents an essential component in wound healing due to its fundamental impact from the very beginning after skin injury until the end of the wound remodeling. Here, the distinct pattern of the neovascularization process and the special new functions of the pericyte will be underscored. At the end, this update will present 3 topics of high interest in skin wound healing issues, dealing with scarring, tissue engineering, and plasma application. Conclusion: Although wound healing mechanisms and specific cell functions in wound repair have been delineated in part, many underlying pathophysiological processes are still unknown. The purpose of the following update on skin wound healing is to focus on the different phases and to brief the reader on the current knowledge and new insights. Skin wound healing is a complex process, which is dependent on many cell types and mediators interacting in a highly sophisticated temporal sequence. Although some interactions during the healing process are crucial, redundancy is high and other cells or mediators can adopt functions or signaling without major complications.

Can Thermal Water Be an Alternative Treatment Method for Wound Healing?

“…Although the wound and wound healing mechanisms have been described clearly; many pathophysiological processes underlying the healing process of the wound and the patient are still unknown (Sorg et al, 2017). However, in order to meet the needs of many unknowns; studies on the availability of water, plant, hot spring and similar paramedical solutions besides medical treatment have been carried out as well as in the past.…”

“…Although wound healing mechanisms and cell functions have been described to a certain extent, many underlying pathophysiological processes are still unknown. Skin and wound healing is a complex process that is dependent on many cell types and mediators that interact in a highly complex temporal sequence (Sorg et al, 2017). As we did not know what will be the result in this pilot study; We generally want to investigate and evaluate the efficacy of this water in terms of the basic wound healing processes.…”

“…As we did not know what will be the result in this pilot study; We generally want to investigate and evaluate the efficacy of this water in terms of the basic wound healing processes. When the situation is evaluated within the framework of the above information (Sorg et al, 2017) ; determination of the effect mechanism of the hot spring water and how these wounds were healed by hot spring water in these patients, who can not obtain results from medical treatment, can be realized with long working chains.…”

“…The human body plays a crucial role in maintaining healthy skin integrity in the maintenance of physiological homeostasis (Sorg et al, 2017). However, acute or chronic traumas, diseases, some infections and surgical operations that can occur for many reasons can lead to deterioration of the integrity of the skin tissue and injuries (Petersen et al, 2016).There are three types of wound form and the healing takes place in three phases.These are primary, secondary and tertiary healing (Brandi et al, 2004).Primer healing; occurs when the sides of the wound are brought together with sutures, staples or tape, and minimal scarring occurs in the wound area.…”

“…However, it can be seen that in many chronic diseases such as diabetes mellutus, peripheral vascular disease (Sorg et al, 2017) and in many cases requiring intervention for wound healing; the medical approach is inadequate. Today, it is known that patients who are desperate in situations where medical treatment is inadequate are seeking remedy with complementary treatments including spas.…”