From Inflammation to Current and Alternative Therapies Involved in Wound Healing

Figure 1

Progression and overlap of the phases involved in the physiological wound healing process: (a) inflammation begins with (1) coagulation, platelet aggregation, and fibrin clot formation; (2) then inflammatory events occur through neutrophils and macrophages infiltration and phagocytosis of debris, apoptotic cells, and pathogens; anti-inflammatory events occur through inhibition of destructive inflammatory process and proliferation promotion. (b) In the proliferation occurs (3) angiogenesis; (4) reepithelization (epithelial cell mitosis and fibroblasts transformation into myofibroblasts), and granulation tissue formation (EMC composed of collagen, glycoprotein, proteoglycan, fibroblasts, and keratinocytes, under modulation of MMP-9). (c) Remodeling is marked by the (5) EMC reorganization: cells apoptosis and angiogenesis regression; and (6) type III collagen replaced by type I.

(a) Inflammation

(b) Proliferation

(c) Remodeling