Introduction

Visible scars, particularly on the face, may have important social and psychological implications and are a significant concern for patients before undergoing surgery. Many new developments in science and medicine have been driven by the desire to minimize or eliminate scars, including endoscopic, minimally invasive and robotic surgeries. Despite these innovations, many procedures still require open incisions, resulting in visible scars, and research into scarless healing continues.

To optimize healing and minimize scarring, an understanding of the wound-healing process is of critical importance. The first phase of wound healing, the inflammatory phase, generally lasts a few days and is characterized by vasodilation and cellular response. The wound must be thoroughly irrigated and meticulously cleaned to maintain asepsis and discourage the persistence of macrophages and other inflammatory cells that prolong inflammation.

The second phase of wound healing, the proliferative phase, is characterized by epithelial regeneration and collagen synthesis. This phase lasts several weeks and may overlap the inflammatory phase. Epithelial regeneration is greatly improved if wounds are closed by primary intention; wounds that heal by secondary intention take much longer for this process.