How do wounds heal?
The largest organ in your body is not your liver or brain. It is your skin with a surface area of approximately two square meters in adults. Although different areas of the skin have different properties, most of the surface has similar functions, such as sweating, feeling heat, or pubescent. However, after a deep incision or wound, the newly healed skin appears different from its circumference and cannot have all of its properties for some time or permanently.
To understand why we need to look at the structure of human skin. The first layer, called epidermis, generally consists of hardened cells called keratinocides and provides protection. Since it is an outer layer, it is constantly poured and renewed. But sometimes a wound can go deep into the dermis, the layer that contains the blood vessels, various glands and nerve endings that provide many functions of the skin. This type of event triggers the start of a four-tiered regeneration process. The first stage, hemostasis, is the reaction of the skin to two immediate threats: you are losing blood now and the physical barrier of the epidermis is broken. As the vessels narrow, to minimize bleeding, in the process known as vasoconstruction, both threats are suppressed by forming a blood clot.
A special protein called fibrin forms cross-links that prevent blood from flowing out and bacteria and pathogens entering. The skin that turns red after three hours in this way signals the next stage of inflammation. By controlling the bleeding and closing the barrier, the body sends special cells to combat pathogens that may have entered. The most important of these are white blood cells known as histiocytes. These cells produce growth factors to consume bacteria and damaged tissue and accelerate healing by phagocytosis.
As these small soldiers must travel through the blood vessels to reach the injured area, the previously narrowed vessels begin to expand again through the vasodilation process. Two to three days after the injury, the prolifertive phase begins with the introduction of fibroplast cells. During the collagen storage process, a fibrous protein called collagen is produced in the wound by forming connective tissue to replace the previous fibrin. As the epidermal cells divide to reshape the upper layer of the skin, the dermis shrinks to close the wound.
Finally, in the fourth stage of the regeneration process, the wound matures by converting the accumulated new collagen into special types. In this process, which can last up to a year, the flexibility of the new skin develops and the vessels and other connections are strengthened. Over time, the new tissue can reach up to 50-80% of the original healthy function, depending on the severity of the initial wound and the function itself.
However, the scars remain a major problem for doctors around the world as the skin has not completely healed. Although researchers have taken important steps in understanding the healing process, many mysteries remain unresolved. For example, do fibroplast cells come from blood vessels or skin tissue close to the wound? Why do other mammals such as deer heal wounds more effectively than humans? By finding answers to these and other questions, perhaps one day we can heal ourselves well enough to remain in memories only.
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