Pathophysiology of the Burn Scar

This chapter reviews current knowledge of the process of wound healing in humans and animals, with special emphasis on abnormal long-term responses to thermal injury. Delays or defects in wound repair lead to aberrant wound healing, and frequently result in pathologic scarring following a severe burn injury. Here we review the wound healing process, including the roles of fibroblasts, keratinocytes, and immune cells in achieving wound closure, the factors that delay wound-healing and result in hypertrophic scarring, and the key pathologic features of hypertrophic scars. Experimental models of hypertrophic scarring—from cell culture to preclinical models to human models—are presented, along with a discussion of areas for further research.