Scar Maturation Process
When an injury occurs a migration of different cells begins immediately and the complex healing mechanism begins in the exact moment it happens.
Saying 'complex' doesn't really do justice in describing the intricately and coordinated level of orchestration that happens between the many cells, organs and products of the defensive system, which do such a wonderful job of keeping our natural, health-filled integrity.
Platelets and inflammatory cells are the first cells to migrate to the place of injury 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 recognized since ancient times: tumor (swelling), calor (heat), rubor (redness) and dolor (pain).
The presence of wound macrophages is a marker that the inflammatory phase is nearing an end and the proliferative phase is commencing. Lymphocytes (white blood cells that help the body and fight infection) come into the damaged area at a later stage.
As the Proliferative phase progresses the predominant cell in the damaged site is the fibroblast. These cells born in the mesoderm that gives rise to the connective tissue of the body, blood vessels and lymph vessels, and is responsible for producing the new matrix necessary to recover structure and function of the injured tissue. Fibroblasts stick to the cables of the temporary fibrin matrix and begin to synthesize collagen.
Collagen is the most abundant protein in the animal kingdom, accounting for 30% of the total protein in the human body. In normal tissues collagen provides strength, stability and structure. Collagen is necessary to repair damage and recover anatomic structure and function. If too much collagen is gathered in the damaged site, normal anatomical structure is lost, function is altered and fibrosis occurs.
The collagen gathered 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, works on the collagen to form stable cross-links. As the collagen matures and turns older, more and more of those intramolecular and intermolecular cross-links are placed in the molecules. This crucial cross-linking step gives collagen its strength and stability over time. Any form of natural scar treatment helps aid and assist normal tissue renewal
In summary, the normal scar healing cascade begins with an orderly process of hemostasis and fibrin deposition, which leads to an inflammatory cell cascade, characterized by neutrophils, macrophages and lymphocytes inside the tissue. This is followed by attraction and proliferation of fibroblasts and collagen deposition, and finally remodeling by collagen cross-linking and scar maturation. Despite this organized sequence of steps responsible for normal scar healing, pathologic responses leading to fibrosis or chronic ulcers can happen if any part of the healing sequence is altered.
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Published November 26th, 2007