TY - JOUR
T1 - Mechanical Forces in Cutaneous Wound Healing
T2 - Emerging Therapies to Minimize Scar Formation
AU - Barnes, Leandra A.
AU - Marshall, Clement D.
AU - Leavitt, Tripp
AU - Hu, Michael S.
AU - Moore, Alessandra L.
AU - Gonzalez, Jennifer G.
AU - Longaker, Michael T.
AU - Gurtner, Geoffrey C.
N1 - Funding Information:
This work was supported by the Howard Hughes Medical Institute.
Publisher Copyright:
Copyright © 2018 Mary Ann Liebert, Inc.
PY - 2018/2
Y1 - 2018/2
N2 - Significance: Excessive scarring is major clinical and financial burden in the United States. Improved therapies are necessary to reduce scarring, especially in patients affected by hypertrophic and keloid scars. Recent Advances: Advances in our understanding of mechanical forces in the wound environment enable us to target mechanical forces to minimize scar formation. Fetal wounds experience much lower resting stress when compared with adult wounds, and they heal without scars. Therapies that modulate mechanical forces in the wound environment are able to reduce scar size. Critical Issues: Increased mechanical stresses in the wound environment induce hypertrophic scarring via activation of mechanotransduction pathways. Mechanical stimulation modulates integrin, Wingless-type, protein kinase B, and focal adhesion kinase, resulting in cell proliferation and, ultimately, fibrosis. Therefore, the development of therapies that reduce mechanical forces in the wound environment would decrease the risk of developing excessive scars. Future Directions: The development of novel mechanotherapies is necessary to minimize scar formation and advance adult wound healing toward the scarless ideal. Mechanotransduction pathways are potential targets to reduce excessive scar formation, and thus, continued studies on therapies that utilize mechanical offloading and mechanomodulation are needed.
AB - Significance: Excessive scarring is major clinical and financial burden in the United States. Improved therapies are necessary to reduce scarring, especially in patients affected by hypertrophic and keloid scars. Recent Advances: Advances in our understanding of mechanical forces in the wound environment enable us to target mechanical forces to minimize scar formation. Fetal wounds experience much lower resting stress when compared with adult wounds, and they heal without scars. Therapies that modulate mechanical forces in the wound environment are able to reduce scar size. Critical Issues: Increased mechanical stresses in the wound environment induce hypertrophic scarring via activation of mechanotransduction pathways. Mechanical stimulation modulates integrin, Wingless-type, protein kinase B, and focal adhesion kinase, resulting in cell proliferation and, ultimately, fibrosis. Therefore, the development of therapies that reduce mechanical forces in the wound environment would decrease the risk of developing excessive scars. Future Directions: The development of novel mechanotherapies is necessary to minimize scar formation and advance adult wound healing toward the scarless ideal. Mechanotransduction pathways are potential targets to reduce excessive scar formation, and thus, continued studies on therapies that utilize mechanical offloading and mechanomodulation are needed.
KW - mechanotransduction
KW - scar
KW - therapy
KW - wound healing
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U2 - 10.1089/wound.2016.0709
DO - 10.1089/wound.2016.0709
M3 - Review article
AN - SCOPUS:85041281355
VL - 7
SP - 47
EP - 56
JO - Advances in Wound Care
JF - Advances in Wound Care
SN - 2162-1918
IS - 2
ER -