We Can Improve Wound Healing

Sabine Werner explains why there’s an urgent need to improve research into wound healing disorders, and why we have good reason to be confident in this area.

wound healing
For many people, a small cut on their finger heals quickly. But for some patients, impaired wound healing poses a major problem. (Photograph: Colorbox)

Time heals all wounds – or so the saying goes. But our ability to heal damaged organs or tissues, such as the skin, is by no means perfect and results in formation of a scar. Scars are more fragile and less elastic than undamaged skin, and they lack hair follicles, sebaceous glands and sweat glands as these do not regenerate. In particular, large wounds like those caused by burns can lead to serious functional and cosmetic impairments.

Salamanders can regenerate their limbs, and freshwater polyps and flatworms can even grow a new head if they lose theirs. Mammals, on the other hand, possess only rudimentary capacities in this area: mice of all ages and children can at least regrow lost finger tips if they still have part of the nail. The fact that humans possess certain regenerative capacities raises hope for scientists like myself that we can activate them more efficiently one day.

The regeneration of entire human limbs is certainly a long way off, and is perhaps something we will never attain. But in my view, improved treatment for wound healing disorders is a realistic research aim for the years ahead.

“Wound healing disorders are on the rise due to
the growing number of aged people.”

Sabine Werner

Frequent healing disorders

Advances in this area are urgently required, as wound healing disorders are on the rise due to the growing number of aged people, patients suffering from diabetes and cancer, and patients undergoing immunosuppressive treatment. These patients often suffer from non-healing skin ulcers, which can be painful, produce an unpleasant smell, and lead to functional impairment. The treatment of skin ulcers also takes a long time and requires ongoing medical care and support. Skin ulcers are a major health problem that significantly reduces the quality of life and the life expectancy of patients.

Large and raised (hypertrophic) scars develop when the healing process is excessive, and pose another wound healing problem. Current treatment options for hypertrophic scars are also limited.

Personalised medicine for wound healing

In order to develop efficient strategies to combat skin ulcers and hypertrophic scars, we need a better understanding of the mechanisms underlying these wound healing disorders. We can gain this through intensive fundamental research using different model organisms, patient tissue and wound exudates.

However, the mechanisms underlying wound healing disorders can differ greatly depending on the location of the wound, its size and depth, infection of the wound with various pathogens, immune system activity, and external stress factors. We therefore need personalised medicine in the field of wound healing to allow us to develop approaches that are specifically tailored to the patients. Research in this area is extremely important and is part of the work carried out by Skintegrity, a large-scale, interdisciplinary project in Zurich that I overse