Mechanical Forces in Cutaneous Wound Healing: Emerging Therapies to Minimize Scar Formation

Leandra A. Barnes, Clement D. Marshall, Tripp Leavitt, Michael S. Hu, Alessandra L. Moore, Jennifer G. Gonzalez, Michael T. Longaker, Geoffrey C. Gurtner

Research output: Contribution to journalReview articlepeer-review

56 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)47-56
Number of pages10
JournalAdvances in Wound Care
Volume7
Issue number2
DOIs
StatePublished - Feb 2018
Externally publishedYes

Keywords

  • mechanotransduction
  • scar
  • therapy
  • wound healing

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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