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

Pathophysiological Consideration
Under normal, physiological conditions, restoration of a functional
epidermal barrier is highly efficient, whereas repair of the deeper layers is
less so and can potentially result in a scar that causes substantial loss of
original tissue structure and function. Meaning: what we see on the surface
can be very different than what may be happening in underlying tissues,
such as the dermis, various CT and fascial layers. In all soft tissues and
organs comprising CT, the parenchymal tissue can be replaced by the
deposition of new ECM. If new ECM deposition is excessive this can
gradually lead to tissue fibrosis and, ultimately, to diminished or loss of
function. In addition to initial damage, ongoing multiple acute or chronic
stimuli, including autoimmune reactions, infections, or mechanical injury
can delay and negatively impact the healing process, resulting in abnormal
remodeling (Guimberteau 2012, Eming et al. 2014).