Cellular and molecular mechanisms of repair in acute and chronic wound healing

SUMMARY: A considerable understanding of the fundamental cellular and molecular mechanisms underpinning healthy acute wound healing has been gleaned from studying various animal models, and we are now unravelling the mechanisms that lead to chronic wounds and pathological healing including fibrosis. A small cut will normally heal in days through tight orchestration of cell migration and appropriate levels of inflammation, innervation and angiogenesis. Major surgeries may take several weeks to heal and leave behind a noticeable scar. At the extreme end, chronic wounds – defined as a barrier defect that has not healed in 3 months – have become a major therapeutic challenge throughout the Western world and will only increase as our populations advance in age, and with the increasing incidence of diabetes, obesity and vascular disorders. Here we describe the clinical problems and how, through better dialogue between basic researchers and clinicians, we may extend our current knowledge to enable the development of novel potential therapeutic treatments. WHAT'S ALREADY KNOWN ABOUT THIS TOPIC? 1. Much is known about the sequence of events contributing to normal healing. . 2. The two pathologies of wound healing are chronic wounds and scarring. . WHAT DOES THIS STUDY ADD? 1. We explain how the cell and molecular mechanisms of healing guide the therapeutic strategies. . 2. We introduce zebrafish and the fruit fly, Drosophila as novel wound healing models. . 3. We highlight unanswered questions and future directions for wound healing research. .