page_title: Scar free healing
section_title: Scar versus scar free healing
hierarchical_section_title: Scar free healing / Scar versus scar free healing
caption_attribution_description: English: Figure 1: A) Collagen fibres in normal skin ‘basket weave’. B) Parallel collagen fibres in scar tissue.
context_page_description: Scar free healing is the process by which significant injuries can heal without permanent damage to the tissue the injury has affected. In most healing, scars form due to the fibrosis and wound contraction, however in scar free healing tissue is completely regenerated. Scar improvement, and scar-free healing are an important and relevant area of medicine. During the 1990s, published research on the subject increased; it's a relatively recent term in the literature. Scar free healing is something which takes place in foetal life but the capacity is lost during progression to adulthood. In amphibians, tissue regeneration occurs, for example, as in skin regeneration in the adult axolotl.
context_section_description: Scarring takes place in response to damaged or missing tissue following injury due to biological processes or wounding: it is a process that occurs in order to replace the lost tissue. The process of scarring is complex, it involves the inflammatory response and remodelling amongst other cell activities. Many growth factors and cytokines are also involved in the process, as well as extracellular matrix interactions. Mast cells are one cell type which act to promote scarring.
  Scarring during healing can create both physical and psychological problems, and is a significant clinical burden which is why the scar free healing concept is of interest. Some of the problems in scar healing lie in the physical outcome of the process: for example when collagen is abnormally organised in scar tissue. In scars the collagen is arranged in parallel bundles of the collagen fibres whilst healthy scar free tissue has a "basket weave" structure (Figure 1). The difference in collagen arrangement along with a lack of difference in the dermal tissue when healing has taken place with or without scarring is indicative of regenerative failure of normal skin. Severe scarring resulting from these collagen deposits is known as hypertrophic scarring and is of great concern worldwide with an incidence ranging from 32–72%.
caption: Figure 1: A) Collagen fibres in normal skin 'basket weave'. B) Parallel collagen fibres in scar tissue.
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