Mechanobiology and Mechanotherapy of Cutaneous Scarring

Cutaneous wound healing involves several phases, the last of which generates the immature scar. In the following months, the scar normally undergoes maturation via tissue remodeling, during which the inflammation and blood vessel and collagen fiber numbers drop. In some cases, however, local, systemic, and/or genetic risk factors provoke ongoing inflammation, which hinders the scar maturation process. This results in pathological scars called hypertrophic scars and keloids. Multiple recent lines of evidence suggest that a particularly important local risk factor for these scars is a mechanical force. Therefore, an important treatment for pathological scars is tension reduction surgery, which is a form of mechanotherapy.