Advertisement

Trauma pp 31-45 | Cite as

Collagen Metabolism in Wound Healing

  • Quentin T. Smith

Abstract

A wound results in disruption of the normal continuity of body structures. Wound healing is restoration of the continuity of injured tissues. Collagen plays a crucial role in healing of wounds of skin and other tissues. There is general agreement that synthesis of collagen is required for restoration of physical strength of wounds. It is now also widely recognized that clarification of the precise role of collagen in the wound healing process requires not only information on the quantity of collagen present during the healing process, but, in addition, data on the rate at which collagen is synthesized, deposited and resorbed. Collagen biosynthesis includes unique biochemical processes, such as hydroxylation of proline to hydroxproline. Activity of these separate biosynthetic steps, likewise, must be evaluated for a thorough understanding of the function of collagen in wound healing. This review will emphasize collagen metabolism of cutaneous wounds not only because of the clinical and therapeutic significance of the healing of surgical incisions, but also since most experiments on collagen in wound healing have used skin injuries. The data to be summarized have been selected mainly from recent studies on “normal” wound healing. Unfortunately, few facts are available concerning collagen metabolism in healing complications such as keloids.

Keywords

Tensile Strength Wound Healing Collagen Synthesis Collagen Content Incisional Wound 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Adamsons, R. J., Musco, F., and Enquist, I. F.: The relationship of collagen content to wound strength in normal and scorbutic animals. Surg. Gyn. Obst. 119:323, 1964.Google Scholar
  2. 2.
    Adamsons, R. J., Musco, F., and Enquist, I. F.: The chemical dimensions of a healing incision. Surg. Gyn. Obst. 123:515, 1966.Google Scholar
  3. 3.
    Bevin, A. G., and Madden, J. W.: Localization of collagen synthesis in healing wounds. Surg. Gyn. Obst. 123:515, 1966.Google Scholar
  4. 4.
    Bryant, W. M., and Weeks, P. M.: Secondary wound tensile strength gain: A function of collagen and mucopolysaccharide interaction. Plast. Reconstr. Surg. 39:84, 1967.CrossRefGoogle Scholar
  5. 5.
    Cramer, L. M., and Hinshaw, J. R.: Autograft rejection induced by homografting. Plast. Reconstr. Surg. 35:572, 1965.CrossRefGoogle Scholar
  6. 6.
    Douglas, D. M.: The healing of aponeurotic incisions. A phenomen intermediate between homograft rejection and autoimmunity. Brit. J. Surg. 40:79, 1952.CrossRefGoogle Scholar
  7. 7.
    Dunphy, J. E., and Udupa, K. N.: Chemical and histochemical sequences in the normal healing of wounds. New Engl. J. Med. 253:847, 1955.CrossRefGoogle Scholar
  8. 8.
    Dunphy, J. E., Udupa, K. N., and Edwards, L. S.: Wound healing. A new perspective with particular reference to ascorbic acid deficiency. Ann. Surg. 144:304, 1956.CrossRefGoogle Scholar
  9. 9.
    Dunphy, J. E.: On the nature and care of wounds. Ann. Roy. Coll. Surg. England. 26:69, 1960.Google Scholar
  10. 10.
    Edwards, L. C., Pernokas, L. N., and Dunphy, J. E.: The use of a plastic sponge to sample regenerating tissue in healing wounds. Surg. Gyn. Obst. 105:303, 1957.Google Scholar
  11. 11.
    Eisen, A. Z., and Gross, J.: The role of epithelium and mesenchyme in the production of a collagenolytic enzyme and a hyaluronidase in the Anuran tadpole. Deve. Biol. 12:408, 1965.CrossRefGoogle Scholar
  12. 12.
    Eisen, A. Z.: Human skin collagenase: Localization and distribution in human skin. J. Invest. Derm. 52:442, 1969.Google Scholar
  13. 13.
    Forrester, J. C., Zederfeldt, B. H., Hayes, T. L., and Hunt, T. K.: Wolff’s law in relation to the healing skin wound. J. Trauma 10:770, 1970b.CrossRefGoogle Scholar
  14. 14.
    Forrester, J. C., Zederfeldt, B. H., Hayes, T. L., and Hunt, T. K.: Tape-closed and sutured wounds: A comparison by tensiometry and scanning electron microscopy. Brit. J. Surg. 57:729, 1970a.CrossRefGoogle Scholar
  15. 15.
    Grillo, H. C., and Gross, J.: Collagenolytic activity during mammalian wound repair. Dev. Biol. 15:300, 1967.CrossRefGoogle Scholar
  16. 16.
    Grillo, H. C., McLennan, J. E., and Wolfort, F. G.: Activity and properties of collagenase from healing wounds in mammals. Centennial Symposium on Wound Healing. Ed., Dunphy, J. E. The Blakiston Division, McGraw Hill, New York, 1968, p. 185.Google Scholar
  17. 17.
    Gross, J., and Lapiere, C. M.: Collagenolytic activity in am phibian tissues: A tissue culture assay. Proc. Natl. Acad. Sci. 48:1014, 1962.CrossRefGoogle Scholar
  18. 18.
    Halme, J., Uitto, J., and Kahanpaa, K.: Protocollagen proline hydroxylase in experimental pulmonary fibrosis in rats. J. Lab. Clin. Med. 75:535, 1970.Google Scholar
  19. 19.
    Hilgert, I.: Changes in the hydroxyproline and hexosamine con tent of grafts after transplantation. Folia Biol. Prague 9:136, 1963.Google Scholar
  20. 20.
    Hinshaw, J. R., and Miller, E. R.: Histology of healing splitthickness, full thickness autogenous skin grafts and donor sites. Arch. Surg. 91:658, 1965.CrossRefGoogle Scholar
  21. 21.
    Houck, J. C., and Jacob, R. A.: The chemistry of local dermal inflammation. J. Invest. Derm. 36:451, 1961.CrossRefGoogle Scholar
  22. 22.
    Howes, E. L., Sooy, J. W., and Harvey, S. C.: The healing of wounds as determined by their tensile strength. J. Amer. Med. Assoc. 92:42, 1929.CrossRefGoogle Scholar
  23. 23.
    Howes, E. L., Harvey, S. C., and Hewitt, C.: Rate of fibroplasia and differentiation in the healing of cutaneous wounds in different species of animals. Arch. Surg. 38:934, 1939.CrossRefGoogle Scholar
  24. 24.
    Klein, L., and Rudolph, R.: 3H-Collagen turnover in skin grafts. Surg. Gyn. Obst. 135:49, 1972.Google Scholar
  25. 25.
    Lagner, R. O., and Fuller, G. C.: Elevation of proline hydroxylase activity in diseased rabbit aorta. Biochem. Biophys. Res. Commun. 36:559, 1969.CrossRefGoogle Scholar
  26. 26.
    Leonard, J.R., Madden, J.W., and Peacock, E.E.: The use of lathyrism to study secondary wound healing. Surg. Gyn. Obst. 133:247, 1971.Google Scholar
  27. 27.
    Levenson, S.M., Geever, E.F., Crowley, L.V., Oates, J.F., Berard, C.W., and Rosen, H.: The healing of rat skin wounds. Ann. Surg. 161:293, 1965.CrossRefGoogle Scholar
  28. 28.
    Madden, J.W., and Peacock, E.E.: Studies on the biology of collagen during wound healing. I. Rate of collagen synthesis and deposition in cutaneous wounds of the rat. Surgery 64:288, 1968.Google Scholar
  29. 29.
    Madden, J.W., and Smith, H.C.: The rate of collagen synthesis and deposition in dehisced and resutured wounds. Surg. Gyn. Obst. 130:487, 1970.Google Scholar
  30. 30.
    Madden, J.W., and Peacock, E.E.: Studies on the biology of collagen during wound healing: III. Dynamic metabolism of scar collagen and remodeling of dermal wounds. Ann. Surg. 174:511, 1971.CrossRefGoogle Scholar
  31. 31.
    Marckmann, A.: Autologous skin grafts in the rat. Biochemical analysis of mucopolysaccharides and hydroxyproline. Proc. Soc. Exp. Biol. Med. 119:794, 1965.Google Scholar
  32. 32.
    Medawar, P.B.: A second study of the behavior and fate of skin homografts in rabbits. J. Anat. 79:157, 1945.Google Scholar
  33. 33.
    Mussini, E., Hutton, J.J. and Udenfriend, S.: Collagen proline hydroxylase in wound healing, granuloma formation, scurvy and growth. Science 157:927, 1967.CrossRefGoogle Scholar
  34. 34.
    Oglivie, R.R., and Douglas, D.M.: Collagen synthesis and preliminary wounding. Brit. J. Surg. 51:149, 1964.CrossRefGoogle Scholar
  35. 35.
    Peacock, E.E.: Some aspects of fibrogenesis during the healing of primary and secondary wounds. Surg. Gyn. Obst. 115:408, 1962.Google Scholar
  36. 36.
    Peacock, E.E.: Inter-and intramolecular bonding in collagen of healing wounds by insertion of methylene and amide crosslinks into scar tissue. Ann. Surg. 163:1, 1966.CrossRefGoogle Scholar
  37. 37.
    Peacock, E.E., and Madden, J.W.: Some studies on the effect of B-amino-propionitrile on collagen in healing wounds. Surgery 60:7, 1966.Google Scholar
  38. 38.
    Ragnell, A.: The secondary contracting tendency of free skin grafts. Brit. J. Plast. Surg. 5:6, 1953.CrossRefGoogle Scholar
  39. 39.
    Reynolds, B. L., Leveque, T. F., and Buxton, R. W.: Metabolic parameters in the healing of open skin wounds in animals. Amer. Surg. 29:325, 1963.Google Scholar
  40. 40.
    Riley, W. B., and Peacock, E. E.: Identification, distribution, and significance of a collagenolytic enzyme in human tissues. Proc. Soc. Exp. Biol. Med. 124:207, 1967.Google Scholar
  41. 41.
    Sandberg, N., and Zederfeldt, B.: The tensile strength of healing wounds and collagen formation in rats and rabbits. Acta Chir. Scand. 126:187, 1963.Google Scholar
  42. 42.
    Sandblom, Ph., and Muren, A.: Differences between the rate of healing of wounds inflicted with short time interval. I. Cutaneous incisions. Ann. Surg. 140:449, 1954.Google Scholar
  43. 43.
    Savlov, E. D., and Dunphy, J. E.: Mechanisms of wound healing: comparison of preliminary local and distant incisions. New Engl. J. Med. 250:1062, 1954a.CrossRefGoogle Scholar
  44. 44.
    Savlov, E. D., and Dunphy, J. E.: The healing of the disrupted and resutured wound. Surgery 36:362, 1954b.Google Scholar
  45. 45.
    Smith, Q. T.: The response of dermal collagen to croton oil injury. J. Invest. Derm. 40:213, 1963.Google Scholar
  46. 46.
    Stein, H. D., and Keiser, H. R.: Collagen metabolism in granulating wounds. J. Surg. Res. 11:277, 1971.CrossRefGoogle Scholar
  47. 47.
    Taffel, M., Donovan, A. J., and Lapinski, L. S.: The effect of trauma on wound healing: An experimental study. Yale J. Biol. Med. 23:482, 1951.Google Scholar
  48. 48.
    Takeuchi, T., and Prockop, D. J.: Protocollagen proline hydroxylase in normal liver and in hepatic fibrosis. Gastroenterology 56:744, 1969.Google Scholar
  49. 49.
    Uitto, J., Halme, J., and Hannuksela, M.: Protocollagen proline hydroxylase activity in the skin of normal subjects and of patients with scleroderma. Scand. J. Clin. Lab. Invest. 23:241, 1969.CrossRefGoogle Scholar
  50. 50.
    Viljanto, J.: Biochemical basis of tensile strength in wound healing. Acta Chir. Scand. suppl. 333:1 1964.Google Scholar
  51. 51.
    Weeks, P. M.: Functional organization of collagen subunits. Surg. Forum 19:59, 1968.Google Scholar
  52. 52.
    Williams, G.: The late phases of wound healing: Histological and ultrastructural studies of collagen and elastic-tissue formation. J. Path. 102:61, 1970.CrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1975

Authors and Affiliations

  • Quentin T. Smith
    • 1
  1. 1.School of DentistryUniversity of MinnesotaUSA

Personalised recommendations