We are using some chemicals to accelerate wound healing response and we saw some of them are accelerating the wound healing response but the dermal thickness is double than the unwounded skin.
There is a normal time course to the healing response. Macrophages and fibroblasts and other cells migrate into a wound to clean up the mess and to lay down the new collagen. There can also be significant edema that persists for many months. Until healing subsides -- which can up to two years in my clinical experience with human wounds -- the dermis will be visibly, palpably, and (no doubt) measurably thicker. But the true final thickness of the skin can only be determined when the cellular infiltrate leaves and when there is no residual swelling.
The double (sometimes even triple) thickness is the normal response seen. This is an inflammatory reaction - as already mentioned above and yes, I agree may take up to 2 years to 'subside'. Application of steroidals and skin care gels such as Dermatix Ultra help reduce the fibrous reaction and 'scarring'. Usually a slightly 'red'scar means it is amenable to treatment while a pale scar means healing is complete.
I agree with all of the aforementioned points, essentially that:
1) Over- or under- action of progenitors and enzymes, that are part of the normal healing cascade;
2) Localized oedema/ inflammation;
... which together lead to scar tissue being less uniform and thus feel thick.
Yes, remodelling shall occur over two years, and may be improved by silicone-based applications and/ or intralesional steroids along with regular, FIRM massage.
Other avenues to consider if wanting to minimize the fibrous nature of the scar tissue are laser resurfacing and autologous lipotransfer supplemented with PRP.
P.S. Remember that foetuses have been shown not to develop scar tissue.
Thank you Niroshan. If in case if some chemical is increasing the rate of wound healing and finaly leading to the dermal thickening as compared to control(without treatment) Is it a good sign?
Actually we are using some chemicals to enhance wound healing purpose and in treatment groups there is accelarated wound healing as compared to control mice. But in treated mice there is increased dermal thickning but in control mice after compleate wound closure there is no dermal thickning. Can this accelarated wound closure can have any impact on increased dermal thickness?
My initial thoughts are whether the chemicals causing the accelerated rate-of-healing have caused a dysregulation of mechanisms that stop ongoing neocollagenesis and/ or whether you've waited enough time for subsequent remodelling (i.e. thinning back down) of the scar tissue (esp. if the amount of healing has overshot what normally happens).
Yes I compleately agree with your suggestions. We have to make sure that neo collagenogenesis is taking place by giving some more time after wound closure and to see if the dermal thickness come to normal thickness.
Normally accelerated wound healing will lead to better scars. If you observe thicker scars after the application of chemical substance, you need to investigate what causes the thickness. Edema, collagen deposition,... Did you measure dermal thickness via ultrasound or histology? This could give you an indication. If the thickness is caused by excessive deposition of collagen, you should check if the chemical substance is not causing fibrosis in the deeper layers of the dermis. Sometimes accelerators of wound healing can cause persistent inflammation in the deeper dermal layers, because they enhance proliferation of fibroblasts.
Hi peter, Yes we checked by the histology it looks like the dermal thickning might be due to increased cellularity....we need to make sure about the types of cells involved in the cellularity and all....
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