Reepithelialisation of Wounds
Reepithelialisation of wounds involves a number of different processes affecting the biology of the keratinocyte. Following breaching of the epidermis the keratinocytes must first migrate across the surface of the denuded area, then mitosis must occur close to the edge to expand the population (Odland and Ross 1968; Krawczyck 1971; Clark 1985). Once keratinocytes have covered the defect they must establish a basement membrane zone, which aids keratinocyte attachment. Then stratification and differentiation must occur to normalise the newly regenerated epidermis. Subsequently the dermis is remodelled, which also involves the keratinocytes by keratinocytemesenchymal interactions mediated by cell contact, diffusible cytokines and extracellular matrix proteins. Replacement of a denuded area of skin by different forms of skin grafts, including keratinocyte sheets, will accelerate the epithelialisation process. These biological processes of keratinocytes will be discussed following an introduction to keratinocyte culture, which provides the basis for many observations applicable to wound healing.
KeywordsWound Healing Bullous Pemphigoid Human Epidermal Keratinocytes Venous Ulcer Skin Equivalent
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- Blair SD, Backhouse CM, Wright DDI, Riddle E, McCollum CN (1988a) Do dressings influence the healing of chronic venous ulcers?. Phlebology 3:129–134.Google Scholar
- Green H (1980) The keratinocyte as differentiated cell type. Harvey Lect Ser 74:101–139.Google Scholar
- Holbrook KA, Wolff K (1987) Structure and development of skin. In: Fitzpatrick TB, Eisen AZ, Wolf K, Freidberg IM, Austen KF (eds) Dermatology in general medicine, 3rd edn. McGraw-Hill, New York, pp 93–131.Google Scholar
- Leigh IM, McKay I, Carver N, Navsaria H, Green C (1991) Skin equivalents and cultured skin: from the Petri dish to the patient. Wounds 3:141–148.Google Scholar
- Mackenzie RC, Sauder DN (1990) Keratinocyte cytokines and growth factors. Dermatol Clin 8:649–661.Google Scholar
- Potten CS, Morris RJ (1988) Epithelial stem cells in vivo. J Cell Sci 10:45–62.Google Scholar
- Winter GD (1972) Epidermal regeneration studied in the domestic pig. In: Maibach HI, Rovee DT (eds) Epidermal wound healing. Year Book Medical Publishers, Chicago, pp 71–112.Google Scholar