[libribook.com] Traumatic Scar Tissue Management 1st Edition

Pathophysiological consideration
Compromised vascularity, local ischemia and resultant hypoxia are primary
factors in poor wound healing. Oxygen plays a key role in every healing
phase including epithelialization, angiogenesis, collagen deposition,
inflammation and bactericidal activity. Fibroblasts require a partial pressure
of oxygen of 30–40 mmHg to synthesize collagen and enzymatic
remodeling of collagen occurs between 20 and 200 mmHg. In comparison,
chronic wounds have been measured to have a partial pressure of oxygen of
5–20 mmHg (Sheffield 1988, Franz et al. 2007, Gordillo & Sen 2003,
Schreml et al. 2010, Gantwerker & Hom 2012).