Surgical Inflammation

Surgical Inflammation

Indexed in: EBSCO, Book Citation Index, Science Edition.

This monograph offers the reader an integrated point-of-view about the inflammatory response related to injury, infections and tumors. This integration is based on the hypothesis that the multiple ...
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The Wound Healing Reaction

Pp. 129-153 (25)

María-Angeles Aller, Isabel Prieto, Javier Blanco-Rivero, Jose-Ignacio Arias, Gloria Balfagon and Jaime Arias

Abstract

The cutaneous wound healing reaction occurs in overlapping but inter-related phases which finally involves fibrosis. The pathophysiological mechanisms involved in fibrotic diseases, including those organ-related or even systemic, like systemic sclerosis, could represent the successive systemic upregulation of extraembryonic-like phenotypes, i.e.: amniotic and vitelline. These two extraembryonic-like phenotypes would focus on the injured tissue to induce a process similar to that occurs in the early phases of embryo development, which is gastrulation. The amniotic-like phenotype would play a leading role in the development of a neurogenic response with noteworthy hydroelectrolytic alterations that essentially would represent the creation of an open microcirculation in the injured tissue. In turn, through the overlapped expression of a vitelline-like phenotype, a bone-marrow-related response is produced. The interstitial infiltration by molecular and cellular mediators contributed by the amniotic- and vitelline-like functions provides the functional and metabolic autonomy which is needed for inducing the formation of a new tissue by using mechanisms similar to those expressed in gastrulation during the early phases of the embryo development. Thus, a new tissue is formed but unfortunately it quickly evolves by premature senescence to fibrosis. The hypothesized use of mechanisms is related to extraembryonic-like functions in the three following physiological and pathological processes: the embryonic development; the wound healing reaction during adult life and, finally in senescence, where the existence of a basic self-organizing fractal-like functional pattern as an essential characteristic of our way of life is suggested.

Keywords:

Wound healing, embryo development, vitelline, clot, coagulation, hemostasis, re-epithelization, amniotic fluid, extraembryonic functions, intraembryonic mesenchyma, leukocytes, microcirculation, senescence, interstitium.

Affiliation:

Cátedra de Cirugía, Facultad de Medicina, Universidad Complutense, Pza. de Ramón y Cajal s.n., 28040 MADRID, Spain.