When speaking about local reactions, various authors agree that three main stages of the wound healing process should be distinguished. Thus, Chernukh AM (1979) distinguished the stage of damage, the stage of inflammation and the stage of recovery.
It is known that the skin is a multifunctional organ that performs respiratory, nutritional, thermoregulatory, detoxifying, excretory, barrier-protective, vitamin-forming and other functions.
Hypertrophic scars are often combined into a group of pathological scars with keloid scars due to the fact that both types are characterized by excessive formation of fibrous tissue and occur as a result of prolonged inflammation, hypoxia, secondary infection, and decreased local immunological reactions. Endocrinopathy is sometimes found in the anamnesis of such patients.
The name keloid comes from the Greek word keleis - tumor and eidos - type, similarity. Keloids are divided into two groups - true or spontaneous and cicatricial or false.
Depending on the location and depth of destructive changes, scars may have different clinical manifestations. Thus, a scar located flush with the skin, not causing deformation of the skin and underlying tissues is called normotrophic.
The basal keratinocyte is not only the mother cell of the epidermis, giving rise to all overlying cells, but also represents a mobile and powerful bioenergetic system.
A deficiency of any components necessary for the implementation of “protective”, physiological inflammation can prolong this process and transfer it to an “inadequate” level.
In response to trauma with damage to the vascular network, an inflammatory process occurs in the skin, which is a natural protective reaction of the body. The purpose of the inflammatory reaction is to remove fragments of damaged skin and, ultimately, to close the skin defect with newly formed tissue in order to maintain homeostasis.
In response to skin damage, neuro-humoral mechanisms come into effect, with the goal of restoring the body's homeostasis by closing the wound defect. And the faster the restoration of the integrity of the skin occurs (the wound epithelialization occurs), the greater the likelihood of either scarless healing or healing with the formation of aesthetically acceptable scars.