Advances in Wound Healing and Skin Regeneration: From Biology to Molecular Mechanisms

Abstract

Introduction: Wound healing is a highly ordered and regulated physiological process for restoring the integrity of the skin after injury. Chronic wounds, such as diabetic ulcers and burns, still represent a significant clinical problem because of compromised cell reactions and disordered molecular signalling. This review aims to familiarise the readers with aspects of skin biology, wound healing processes, and basic cellular and molecular regulators of tissue repair and regeneration.

Methods: This review provides a narrative synthesis of the literature focusing on skin structural organisation, phases of wound healing, cellular dynamics, signalling pathways, growth factors, ECM remodelling, and oxidative stress.

Results and Discussion: Wound healing occurs in four overlapping phases: hemostasis, inflammation, proliferation, and remodelling. Adjacent to each other, keratinocytes, fibroblasts, endothelial cells, and immune cells communicate to orchestrate re-epithelialization, collagen deposition, angiogenesis, and immune regulation during the healing process. Specific pathways associated with molecular, such as MAPK/ERK, PI3K/Akt, NF-κB, and TGF-β/Smad, are of great significance for controlling proliferation, survival, inflammation and extracellular matrix synthesis. Growth factors (eg, EGF, VEGF, PDGF) and cytokines add another layer of complexity in modulating healing, whereas oxidative stress and its dual effects, both beneficial and detrimental, are dependent on oxidative stress levels. The deregulation of these mechanisms leads to the occurrence of chronic wounds.

Conclusion: A detailed knowledge of such integrated mechanisms will aid in designing novel, innovative and personalised therapeutic approaches to improve wound healing and skin regeneration.