Histomorphological skin changes in the wound healing process after surgical intervention

Abstract

Introduction: The process of wound healing is best represented by an uninfected surgical wound. It is characterized by the formation of granulation tissue, with migration and proliferation of fibroblasts, neoangiogenesis and production of extracellular matrix. Granulation tissue is gradually replaced by scar made up of connective tissue and, in most cases - the process is ended up in three or four weeks. The whole process takes about six weeks and a newly formed scar has approximately 90% of strength of the intact skin. Aim: The aim of this paper is the examination of histomorphological changes in the skin during wound healing by first intention. Material and methods: Six groups are formed based on the age of the wounds. In each group we searched for changes in epidermis, collagen fibers, fibroblasts, capillaries, inflammatory infiltrate and hypodermis. Tissue biopsies were stained with hematoxylin-eosin, Mallory trichrome stain, silver impregnation and immunohistochemically for CD31, collagen IV and h-caldesmon. Results: Analyzing the wounds in different stages of healing we have observed histomorphological changes that could be described chronologically. In each group we chose the most representative biopsy with visible location of surgical cut, and clear histological changes of the repairing process specific for every period. Conclusion: After the surgical incision, the process of skin repair takes place to form a new scar made up of tissue different from the surrounding intact skin. The scar shows irregular architectonics of collagen fibers, loss of skin appendages in dermis, and thicker epidermis.