Özlem SİLİSTRELİ^a
aPrivate Practice, İzmir, Türkiye

Silistreli Ö. Inflammatory response in wound healing and tissue repair. In: Koçdor H, Pabuççuoğlu A, Zihnioğlu F, eds. Inflammation and in vitro Diagnostics. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.99-105.

Article Language: EN

ABSTRACT
Inflammation, which is the second phase of wound healing, can be defined as the immune response of the organism against tissue damage. Considering that most of the injuries that occur on the skin in the evolutionary process are contaminated wounds, inflammation comes into play as a defense mechanism to prevent infection. This process, in which many cell types such as platelets, neutrophils, macrophages, mast cells, lymphocytes, keratinocytes, and dendritic cells play an active and synergistic role, provides debridement of the wound area before the repair phase begins, while forming a defense mechanism against infectious agents, and also acts as a secondary causes tissue destruction. The effects of vasoactive amines, plasma proteases, arachidonic acid metabolites, free radicals and cytokines secreted from inflammatory cells cause clinical symptoms such as edema, temperature increase and pain in the wound area. Chemotactic inflammatory mediators secreted from the cells also ensure that cell types such as fibroblasts and keratinocytes are brought to the environment, which will enable the wound to be repaired, that is, to proceed to the proliferation stage. With the effect of growth factors secreted from many cell types in the environment, neovascularization, collagen synthesis (granulation tissue formation), matrix formation and thus wound repair occur. Fetal wound healing involves little inflammation, scarless regeneration, and complete restoration of dermal structures. It is known that some tissues such as oral mucosa heal with minimal inflammation and minimal scarring in adults. The inflammation process lasts for 1-3 days in a normal wound healing, the prolongation of this process appears as a ”chronic wound” in the clinic. So why is there such a phase in wound healing? The answer to this question is hidden in the evolutionary process. Injuries that occurred in primitive times were animal bites, falls, and contaminated injuries in the form of injuries with stones and branches. It was not possible to clean these wounds in a hygienic environment and to protect them from infection with the help of antibiotics. In this case, the organism had to remove dead cells, infectious agents and foreign bodies formed in the wound area with its own mechanisms. Inflammation was necessary at this stage. However, nowadays, more controlled healing of the wound can be achieved. The fact that the inflammation process is particularly long and intense, delaying the repair process has paved the way for many studies to take this process under control.

Keywords: Inflammation; wound healing; scar formation