#156 Scar mark by a cut (1) (English)

Scar mark by a cut 

The healing process of a cut can be distinguished into 3 periods as following:

Although there are some cases when healing process does delay, normally it lasts approximately 21 days. As shown in the graph, there are consecutive processes – hemostasis and coagulation, inflammation, epithelization, proliferation, and maturation – for the complete heal.

1. Hemostasis and inflation

This is when the tissues that have been damaged either due to the harm or necrosis and foreign substances are removed. This is the most important step that ultimately influences the subsequent treatments. This process can be easily understood by comparing to a situation wherein a wall is broken down, and to restore it, one has to clean and organize the place. To proceed this step, the body produces several kinds of inflammatory cells that secrete substances that induce the growth of new tissues.

2. Mesenchymal cell migration and proliferation, angiogenesis, epithelialization

Mesenchymal cell moves to the wound and proliferates. This cell promotes growth of new blood vessels and differentiation of cells in the skin epithelium layer. Consequently, the wound is covered by the epithelium.

3. Collagen synthesis, wound contraction, proteoglycan synthesis

During this step, the granulation tissue is newly synthesized. Fibrosis blast cell is transported towards the site of the wound and synthesize collagen fiber, which is one of the crucial connective tissues. Also, proteoglycan, fibronectin and elastin are also synthesized. Hence, during this process, the extension strength of the skin of the wound increases abruptly. Simultaneously, the scar of the wound initiates to soar.

4. Wound remodel

The inflammatory cells are removed and vascularization and fibrosis progress halts. During this step, the collagen fiber undergoes both synthesis and atrophy. As the collagen synthesis augments, the scar is excessively formed, causing a dark red protrusion. After 6 months, the collagen fiber is reorganized incrementally, leading to a decrease in the proteoglycan, which pressures the blood vessels making the scar fade. If the red scar is present continuously as its soared state, it is known as the hypertrophic scar. Furthermore, if the scar proliferates even beyond the wound site, it is called keloid.

To sum up, a scar is healed as it matures after inflammation and epithelialization. During the inflammation, the bleeding is stopped, and the cells required for healing moves to the wound site. Then, the skin epithelium is reproduced during epithelialization. In proliferation, for the derma to maintain the tension, the extension strength of the wound site is strengthened. At last, in maturation, the tissue is the derma is rearranged to return to its original condition. To prevent the wound from leaving a scar, suitable treatments must be undergone for each step to minimize the ache and the scar.

LCY