Fötal yara iyileşmesi

Yara iyileşmesinin temel süreçlerinden biri olan skar oluşumu, fonksiyonel, kozmetik ve gelişimsel açıdan, özellikle çocuklarda olumsuz etkileri olan önemli bir tıbbi problemdir. Hayvan modellerinde, fötal deride yara iyileşmesinin makroskopik olarak minimal veya tamamen skarsız meydana geldiğinin tespit edilmesi, cerrahları fötal yara iyileşmesinin biyolojisine ve erişkinlerdeki yara iyileşmesinin manipülasyonuna yönlendirmiştir. Erişkinde eksizyonel yara iyileşmesi, akut infl amasyon, fibroblast proliferasyonu, anjiogenezis, kollajen ve matriks sentezi, kontraksiyon ve fibrozisden oluşmaktadır. Sonuçta olgun skar dokusu içeren kapanmış bir yara elde edilir. Fötusta ise eksizyonel yara iyileşmesi, infl amasyon, granülasyon dokusu, yara kontraksiyonu ve kollajen depolanması olmadan gerçekleşmektedir. Erişkin ve fötal doku yara iyileşmesi arasındaki bu farklılıklar, fötusun yara iyileşmesinde gösterdiği özelliklerin erişkine uyarlanması açısından önemlidir. Fötal yara iyileşmesi biyolojisinin daha açık ve net bir şekilde ortaya konması, ileride yetişkinlerde cerrahi müdahale veya travmaya bağlı skar formasyonunu önlemekte büyük bir imkan yaratacaktır

Fetal wound healing

Fetal Wound Healing Scarring which is one of the fundamental processes of wound healing is a major medical problem having adverse functional, cosmetic and development eff ects especially in children. The discovery that fetal skin wounds in animal models heal with minimal or no scarring(macroscopically) has directed surgeons to the biology of fetal healing and the manipulation of adult wound healing. Excisional wound healing in adults occur with acute infl ammation, fibroblast proliferation, angiogenesis, collogen and matrix syntesis, contraction and fibrosis, while fetal excisional wound healing is without infl ammation, granulation tissue, wound contraction and collogen deposition. Future developments leading to a better understanding of fetal wound healing biology seem to create new possibilities at prevention of scar formation due to surgical interventions or traumas in adults.

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