Fetal Wound Repair

Abstract

The process of wound repair has phylogenetically evolved as an essential survival process after injury. While some lower species retain the ability to regenerate, humans require rapid healing lest they succumb to infection, predators or starvation during evolution. Thus it is likely that wound healing in the form of rapid collagenous scar deposition evolved. The original demonstration that the mammalian fetus retains the ability to heal in a scarless fashion [1–3], resembling regeneration, reinforced the importance of restoration of original structure and function. These studies have suggested important therapeutic strategies in modulating pathologic adult wound healing. For example, can we modulate adult repair to prevent the formation of keloids and hypertrophic scarring? Will the study of the noncontracting fetal skin wound teach us how to control burn scar contracture or common bile duct stenoses? In an attempt to address these and other questions, fetal wound repair has been a major focus of research in our laboratory for the past 5 years. It is hoped that by delineating the mechanisms whereby the fetus carries out optimal wound repair, resembling regeneration, pathologic adult wound healing problems may be ameliorated.