Scars Maturation
December 13th, 2007When an injury occurs a migration of different cells begins immediately and the complex healing process initiates in the exact moment it happens.
Saying ‘complex’ doesn’t really do justice in describing the intricately and coordinated level of orchestration that occurs between the many cells, organs and products of the immune system, which do such a masterful job of keeping our biological, health-filled integrity.
Platelets and inflammatory cells are the first cells to migrate to the site of damage and they provide key functions and ’signals’ needed for the arrival of connective tissue cells and a renovated blood supply. This phase is named inflammatory phase. The signs have been well known since ancient times: rubor (redness), calor (heat), tumor (swelling) and dolor (pain).
The presence of wound macrophages is a signal that the inflammatory phase is nearing an end and the proliferative phase is beginning. Lymphocytes (white blood cells that help the body and fight infection) come into the damaged area at a later stage.
As the Proliferative phase advances the predominant cell in the damaged site is the fibroblast. These cells originate in the mesoderm that creates the connective tissue of the body, blood vessels and lymph vessels, and is responsible for creating the new matrix necessary to restore structure and function of the damaged tissue. Fibroblasts stick to the cables of the provisional fibrin matrix and start to produce collagen.
Collagen is the most abundant protein in the animal kingdom, accounting for 30% of the total protein in the human body. In healthy tissues collagen ensures firmness, stability and structure. Collagen is necessary to repair damage and restore anatomic structure and function. If too much collagen is deposited in the wound, normal anatomical structure is lost, function is compromised and fibrosis occurs.
The collagen released into the extracellular matrix undergoes further modifications by freeing of the procollagen N and C-terminal peptides. In the extra-cellular matrix a crucial enzyme, lysyl oxidase, acts on the collagen to form stable cross-links. As the collagen stabilizes and becomes older, more and more of these intramolecular and intermolecular cross-links are established in the molecules. This important cross-linking step gives collagen its firmness and stability over time. Any form of natural scar treatment helps aid and assist normal tissue renewal
In short, the healthy scar healing cascade begins with an orderly process of hemostasis and fibrin deposition, which leads to an inflammatory cell cascade, recognized by neutrophils, macrophages and lymphocytes within the tissue. This is followed by migration and proliferation of fibroblasts and collagen deposition, and finally remodeling by collagen cross-linking and scar establishment. Despite this organized sequence of events responsible for normal scar healing, pathologic reactions leading to fibrosis or chronic ulcers can occur if any part of the healing cascade is altered.
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- Katherine Hampton
