Application of plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue to repair skin defects in hands and feet / 中国修复重建外科杂志

OBJECTIVE@#To explore the feasibility and effectiveness of plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue to repair skin defects in hands and feet.@*METHODS@#Between July 2017 and January 2023, 35 cases of hand and foot defects were repaired with plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue (13 pedicled flaps and 22 free flaps). There were 18 males and 17 females, with an average age of 38.8 years (range, 8-56 years). Thirty cases of defects were caused by trauma, and the interval between injury and admission ranged from 2 to 6 hours (mean, 3.3 hours). Three cases were ulcer wounds with a course of 3.0, 3.8, and 7.0 months, respectively. Two cases were malignant melanoma. Eight cases of wounds located in the fingers, 13 cases in the palm, 12 cases in the heel, and 2 cases in the distal foot. The size of skin defects ranged from 4.0 cm×3.5 cm to 12.0 cm×10.0 cm, and the size of flap ranged from 5.0 cm×4.5 cm to 13.0 cm×11.0 cm. The donor sites were repaired with skin grafts.@*RESULTS@#All flaps were survived and the wounds healed by first intention after operation. The partial necrosis at the edge of the skin graft occurred in 1 case, which healed after dressing change; the other skin grafts survived successfully. All patients were followed up 6-24 months (mean, 18 months). The flaps exhibited similar color and thickness to the surrounding hand and foot skin. Two-point discrimination ranged from 7 to 10 mm in the flaps with an average of 8 mm. The donor sites had no painful scars or sensory abnormalities. Foot and ankle functions were good and gaits were normal.@*CONCLUSION@#Application of plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue to repair skin defects in hands and feet had good flap shape, high survival rate of skin graft at the donor site, and no obvious complications.

Walnut ointment promotes full-thickness burning wound healing: role of linoleic acid

Purpose: To investigate the active ingredients of walnut ointment (WO) and its mechanism in repairing wounds. Methods: The ingredients of WO were detected by gas chromatography­mass spectrometry. The effect of linoleic acid (LA) was tested by in vitro Alamar Blue (AB) reagent. Image J software, histological and immunohistochemical analysis were used to confirm the healing effect of LA in the porcine skin model. The animals were euthanized after the experiment by injection of pentobarbital sodium. Results: LA, 24% in WO, promotes keratinocytes and fibroblasts proliferation, which were 50.09% and 15.07% respectively higher than control (p < 0.05). The healing rate of the LA group (96.02% ± 2%, 98.58% ± 0.78%) was higher than the saline group (82.11% ± 3.37%, 88.72% ± 1.73%) at week 3 and week 4 (p < 0.05). The epidermal thickness of the LA was 0.16 ± 0.04 mm greater and the expression of the P63 and CK10 proteins was stronger in the LA group than the control (p < 0.05). Conclusions: LA, which is the main components in WO can promote full-thickness burning wounds (FBWs) by stimulating cell proliferation and differentiation.

Scar-free wound healing following full-thickness cutaneous wounding in the tail and body of Scincella tsinlingensis / Cicatrización de heridas sin cicatrices luego de heridas cutáneas de espesor total en la cola y el cuerpo de Scincella tsinlingensis

SUMMARY: The cutaneous wounds of trunk and tail healing scar-free or with scar were different in lizard species. Full- thickness cutaneous injuries of tail and body of Scincella tsinlingensis were examined by histomorphological and immunohistochemistrical methods. The results showed that all injuries healed without scarring. The process of the wound healing of S. tsinlingensis involved hemostasis, re-epithelialization, proliferation and remodelling, which also could be further subdivided into six stages. Stage I, 0-2 day post wound (dpw), the blood oozed gradually, no obvious wound contraction, minimal blood loss. Stage II, 2-10 dpw, the wound bed covered by the fibrin clot of blood, tissue fluid and tissue debris. Stage III, 7d-15 dpw, the wrinkled wound epitheliums was gradually stratified, and its surface was keratinized and exfoliated. Stage IV, 10-28 dpw, pigment cells were distributed at the boundary between epidermis and dermis, with few blood vessels and no granulation tissue formation. Stage V, 20-70 dpw, opaque scales covered the wound epithelium with randomly scattered melanophores in the base of the epidermis. Stage VI, 45-135 dpw, the epidermis and dermis restored to the thickness of the original skin. Regenerated scales were similar to scales of the uninjured dermis. The positive immunostaining of matrix metalloproteinases-9, cytokeratin 6, alpha smooth muscle actin, caspase 3 and transforming growth factor-β3 showed the specificity of healing period and different stages, which participated in skin wounds healing of S. tsinlingensis.

RESUMEN: En las diferentes especies de lagartos las heridas cutáneas del tronco y la cola sin cicatrices, o con algún tipo de cicatriz son diversas. En este estudio se examinaron las heridas cutáneas de espesor total de la cola y el cuerpo de Scincella tsinlingensis mediante métodos histomorfológicos e inmunohistoquímicos. Los resultados indicaron que todas las lesiones sanaron sin cicatrices visibles. El proceso de cicatrización de heridas de S. tsinlingensis implicó hemostasia, reepitelización, proliferación y remodelación, que también podrían subdividirse en seis etapas. Etapa I, 0-2 días después de la herida (dph), la sangre filtraba gradualmente, sin contracción evidente de la herida, con pérdida mínima de sangre. Etapa II, 2-10 dph, el lecho de la herida estaba cubierto por el coágulo de sangre, líquido tisular y restos tisulares de fibrina. Etapa III, 7-15 dph, los epitelios de la herida se estratificaron gradualmente y su superficie se queratiniza y exfolia. Etapa IV, 10-28 dph, las células pigmentarias se distribuyeron en el límite entre la epidermis y la dermis, con pocos vasos sanguíneos y sin formación de tejido de granulación. Etapa V, 20-70 dph, escamas opacas cubrieron el epitelio de la herida con melanóforos dispersos al azar en la base de la epidermis. Etapa VI, 45-135 dph, la epidermis y la dermis restauradas al grosor de la piel original. Las escamas regeneradas eran similares a las escamas de la dermis sin herida. La inmunotinción positiva de metaloproteinasas- 9 de matriz, citoqueratina 6, actina de músculo liso alfa, caspasa 3 y factor de crecimiento transformante-β3 mostró la especificidad del período de curación y las diferentes etapas, que participaron en la curación de heridas cutáneas de S. tsinlingensis.

Exosomes from Stem Cells Loaded by Hydrogel in Skin Wound Repair / 中国生物化学与分子生物学报

Skin wound healing is one of the difficult problems in clinical medicine. The long-term wound healing has a great impact on patients and causes huge social and economic burden. Hydrogels have good biocompatibility, biodegradability and plasticity, and have excellent properties of hemostasis, antibacteri-al and water retention. They are widely used as skin wound dressing. The exosomes derived from stem cells contain the unique contents and membrane components of stem cells. These exosomes have the simi-lar repair function as stem cells, and avoid the safety problems of teratoma and graft immune rejection caused by stem cell therapy, and therefore has become the research hotspot of cell-free repair. However, exosomes in the treatment process will face high clearance rate, short half-life and difficulty in large-scale preparation, which limits the therapeutic effect of exosomes. Hydrogel loaded stem cell exosomes can not only prevent exosome from being rapidly removed, but also play the role of exosome and hydrogel in pro-moting wound healing, skin repair synergy, and thereafter has potential application value in wound repair research. In this paper, production and characteristics of exosomes, commonly used hydrogel materials, stem cell exosomes from different sources, exosomes extraction and identification methods have been sum-marized. Furthermore, stem cell exosomes related mechanisms of wound repair, protective and sustained release effects of hydrogel on exosomes, and synergistic effects of hydrogel and exosome are also reviewed. This paper provides a reference for the future research in the field of skin repair.

Flap bipedicular no tratamento de lesão cutânea traumática em membro torácico de gato: relato de caso / Bipedicular flap in the treatment of traumatic skin injury in cat thoracic member: case report

O objetivo do presente estudo é relatar a construção de um retalho direto de bolsa bipediculada com fixação apendicular à região torácica para o tratamento de lesões extensas no membro torácico direito de um gato. Foi tratado no Hospital Veterinário Unicesumar Maringá - Paraná, um felino de 1 ano de idade, apresentando lesão no membro torácico, após história de briga com outro animal da mesma espécie. Ao exame físico, apresentava fístula e edema no membro torácico direito. O paciente foi anestesiado e foi realizado o desbridamento das áreas desvitalizadas. Como terapia inicial, a lesão foi tratada como ferida aberta, até a formação de tecido de granulação, para posterior correção do defeito empregando retalho bipediculado em bolsa direta, com fixação temporária do membro à parede torácica. Após duas semanas, o membro foi desimplantado e os pontos foram removidos 21 dias após a aplicação do retalho. O uso do retalho permitiu completa cicatrização da ferida, sem ocorrência de hematomas, necrose ou deiscência de sutura. Conclui-se que a utilização do retalho bipedicular é aplicável ao tratamento de feridas traumáticas em membro torácico de felinos.

The aim of the present study is to report the construction of a direct bipedicled pouch flap with appendicular fixation to the thoracic region for the treatment of extensive lesions in the right thoracic limb of a cat. He was treated on Hospital Veterinário Unicesumar Maringá - Paraná, a 1-year-old feline, presenting injury to the thoracic limb after a history of fighting with another animal of the same species. On physical examination, he presented fistula and edema in the right thoracic limb. The patient was anesthetized and debridement of the devitalized areas was performed. As an initial therapy, the lesion was treated as an open wound until granulation tissue was formed for subsequent correction of the defect using a direct pouch bipedicled flap, with temporary fixation of the limb to the chest wall. After two weeks, the limb was unimplanted and the stitches were removed 21 days after flap application. The use of the flap allowed complete wound healing without bruising, necrosis or suture dehiscence. It is concluded that the use of bipedicular flap is applicable to the treatment of traumatic wounds in feline thoracic limb.

Research progress in mesenchymal stem cell-derived exosomes repairing skin tissues / 中华创伤杂志

Mesenchymal stem cells ( MSCs) play an important role in skin wound repair because of their multi-directional differentiation potential, hematopoietic support and promotion of stem cell implantation, immune regulation and self-replication. Exosomes contain proteins and RNAs, which have anti-tumor immunity, angiogenesis promotion and other physiological functions. Different MSCs-derived exosomes have different mechanisms in the skin traumatic action. The author summarizes the research progress of different MSCs-derived exosomes in the field of skin tissue repair through elaborations on the traditional treatment methods for skin damage, the biological properties of exosomes, the mechanism of MSCs-derived exosomes in skin wound repair and in other diseases, providing reference for improving clinical repair.

Research progress in mesenchymal stem cell-derived exosomes repairing skin tissues / 中华创伤杂志

Mesenchymal stem cells (MSCs) play an important role in skin wound repair because of their multi-directional differentiation potential, hematopoietic support and promotion of stem cell implantation, immune regulation and self-replication. Exosomes contain proteins and RNAs, which have anti-tumor immunity, angiogenesis promotion and other physiological functions. Different MSCs-derived exosomes have different mechanisms in the skin traumatic action. The author summarizes the research progress of different MSCs-derived exosomes in the field of skin tissue repair through elaborations on the traditional treatment methods for skin damage, the biological properties of exosomes, the mechanism of MSCs-derived exosomes in skin wound repair and in other diseases, providing reference for improving clinical repair.

The Effect of Flaxseed Extract on Skin Elasticity of The Healing Wound In Rabbits

@#Introduction: Management of disturbed wounds, large skin defects and the areas where skin tension precludes wound closure is of high clinical importance. Healing in wounds occurs through epithelization and contraction processes (second-intentions healing) that may result in certain undesirable complications including keloid and formation of a fragile epithelial layer. Materials and methods: 27 white New Zealand rabbit included in this study divided into 3 groups; one group of 9 rabbits received Flaxseed gel topically for three time intervals (1, 7, and 14 days); a second group received Fucidin cream as positive control, while a third group has not received any treatment as negative control, Skin elasticity measurements were performed using the DermaLab system. Results: Throughout the study, skin elasticity was significantly greater in Flaxseed group than in others. Flaxseed decrease elasticity value from (3.46 ± 2.05). Hence, Young's modulus of skin elasticity in flaxseed group was (2.46 ± 1.02) after 14 days (p = 0.003), while no significant differences were evident in both Fucidin group (1.16 ± 0.77) and non-treated group (1.86 ± 1.40) (p = 0.019), accordingly flaxseed extract more reproducible than other groups demonstrating comparable efficacy in skin elasticity and distensibility. Conclusions: This study showed the therapeutic effect of flaxseed on biologic tissue. Elasticity evaluation demonstrated increased density and firmness in the network of collagen fibers in the dermis and subcutis during wound healing process promise in generating therapeutic gel to be used in wound healing process.

The therapeutic effect of rh-aFGF carbomer 940 gel on wound healing in type I diabetic SD rat models / 中国药理学通报

Aim To study the therapeutic effect of re-combinant human acidic fibroblast growth factor (rh-aFGF) carbomer 940 gel in the treatment of skin wound healing in type I diabetic rats. Methods Two types of skin trauma models, namely, full-thickness wound and scalded wound,were established in a model of type I diabetes mellitus using STZ-induced SD rats. The rats were divided into control group, vehicle group,90 AU rh-aFGF gel group and 270 AU rh-aFGF gel group in each skin wound models. The wound area and wound healing rate were used to evaluate the thera-peutic effect. The growth of fibroblasts, fibrocytes, collagen fibers and vessel capillaries in the wound was observed using HE staining and analysed by semi-quantitative score. Results The rh-aFGF carbomer gel significantly reduced the traumatic area as well as promoted the wound healing rate of the skin trauma model of SD rats of type I diabetes mellitus (P <0.05). HE staining showed that rh-aFGF carbomer gel significantly promoted the pathological score of fibro-blasts and collagen fibers(P<0.05). Conclusions rh-aFGF carbomer gel might play a protective role in micro-environment of wound and rh-aFGF, which could benefit for proliferation of fibroblasts and colla-gen, therefore promoting the healing process of skin wound in SD rats with type I diabetes mellitus, and it might be expected to be a new preparation for the treat-ment of chronic trauma in diabetes mellitus.

Roles of Nerve in Regeneration and Scar Healing of Skin Wound (review) / 中国康复理论与实践

Nerve is the foundation of the physiological function such as the skin feeling and thermoregulation, and also regulates the re-generation and scar healing of skin wound by multiple mechanisms. Though the denervated skin wound can heal spontaneously, the nerve might accelerate wound healing by activating the neurogenic inflammation and nerve trophism, increasing the blood supply around the wound, promoting the proliferation of fibroblasts and keratinocytes, stimulating the expression of collagen I and III, and interacting with im-mune system and releasing neuropeptides. If all kinds of repair cells, extracellular matrix, nerve, blood vessel and cutaneous appendages as-semble organically, the skin wound regenerates, and otherwise the scar heals. The nerve axon growth occurs mainly in the early stage of the wound healing and the scar rebuilding process, and the nerve growth rate is obviously slower than the granulation tissue formation and cica-trization. Furthermore, the axon growth of different nerve fibers are not entirely the same. The exogenous neuropeptides might promote the wound repair and the nerve regeneration. The antagonist of the neuropeptides or high selective nerve abscission might reduce the scar hyper-plasia. Therefore, it contribute to find methods to promote the regeneration of skin wound and peripheral nerve injury by understanding the effects and regulatory mechanism of both nerve and various repair elements in regeneration or scar healing of skin wound.

Roles of Nerve in Regeneration and Scar Healing of SkinWound (review) / 中国康复理论与实践

@#Nerve is the foundation of the physiological function such as the skin feeling and thermoregulation, and also regulates the regeneration and scar healing of skin wound by multiple mechanisms. Though the denervated skin wound can heal spontaneously, the nerve might accelerate wound healing by activating the neurogenic inflammation and nerve trophism, increasing the blood supply around the wound, promoting the proliferation of fibroblasts and keratinocytes, stimulating the expression of collagen I and III, and interacting with immune system and releasing neuropeptides. If all kinds of repair cells, extracellular matrix, nerve, blood vessel and cutaneous appendages assemble organically, the skin wound regenerates, and otherwise the scar heals. The nerve axon growth occurs mainly in the early stage of the wound healing and the scar rebuilding process, and the nerve growth rate is obviously slower than the granulation tissue formation and cicatrization. Furthermore, the axon growth of different nerve fibers are not entirely the same. The exogenous neuropeptides might promote the wound repair and the nerve regeneration. The antagonist of the neuropeptides or high selective nerve abscission might reduce the scar hyperplasia. Therefore, it contribute to find methods to promote the regeneration of skin wound and peripheral nerve injury by understanding the effects and regulatory mechanism of both nerve and various repair elements in regeneration or scar healing of skin wound.

Overview of Surgical Scar Prevention and Management

Management of incisional scar is intimately connected to stages of wound healing. The management of an elective surgery patient begins with a thorough informed consent process in which the patient is made aware of personal and clinical circumstances that cannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. Traditional incisions most often follow relaxed skin tension lines, but no such lines exist in high surface tension areas. If such incisions are unavoidable, the patient must be informed of this ahead of time. The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. Patient participation is paramount in obtaining the optimal outcome. Postoperative visits should screen for signs of scar hypertrophy and has a dual purpose of continued patient education and reinforcement of proper care. Early intervention is a key to control hyperplastic response. Hypertrophic scars that do not improve by 6 months are keloids and should be managed aggressively with intralesional steroid injections and alternate modalities.

Effects of low-frequency electromagnetic fields on skin wound healing after the transplantation of gene modified epidermal stem cells / 中国组织工程研究

BACKGROUND:The repair and management of ful-thickness skin defects resulting from burns and chronic wounds remain a significant unmet clinical chal enge. Using epidermal stem cel s and keratinocyte growth factor for ful-thickness wound repair is a promising approach. Low-frequency electromagnetic fields which are a non-invasive physical stimulation therapy have been recognized as a good method to enhance wound healing. OBJECTIVE:To develop a new strategy to accelerate wound healing by transplanting transfected epidermal stem cel s and keratinocyte growth factor and treating with low-frequency electromagnetic fields in a mouse model. METHODS:Epidermal stem cel s from Sprague-Dawley neonatal rats were isolated and cultured in vitro, then the cel s were labeled with 5-bromo-2-deoxyuridine and transfected by Ad-KGF, a recombinant adenovirus carrying the keratinocyte growth factor. Mice were given to create ful thickness skin wound on the dorsum and randomly assigned to four groups:control group, transplantation of epidermal stem cel s group, transplantation of keratinocyte growth factor gene modified epidermal stem cel s group, and transplantation of keratinocyte growth factor gene modified epidermal stem cel s plus low-frequency electromagnetic field exposure group. RESULTS AND CONCLUSION:The best healing pattern was observed in the keratinocyte growth factor gene modified epidermal stem cel s plus low-frequency electromagnetic field exposure group (P<0.05) at days 9 and 16. 5-Bromo-2-deoxyuridine labeled cel s existed in the wound in the treated groups at day 9. A significantly increased expression of endogenous keratinocyte growth factor was detected in the transplantation of Keratinocyte Growth Factor gene modified epidermal stem cel s group, and transplantation of keratinocyte growth factor gene modified epidermal stem cel s plus low-frequency electromagnetic field exposure group at day 16. A wel-advanced epithelialization was observed in transplantation of keratinocyte growth factor gene modified epidermal stem cel s plus low-frequency electromagnetic field exposure group at days 16 and 30. These results suggest that low-frequency electromagnetic fields enhanced wound healing fol owing the transplantation of keratinocyte growth factor gene modified epidermal stem cel s.

Comparison of EGF with VEGF Non-Viral Gene Therapy for Cutaneous Wound Healing of Streptozotocin Diabetic Mice

BACKGROUND: To accelerate the healing of diabetic wounds, various kinds of growth factors have been employed. It is the short half-life of administered growth factors in hostile wound beds that have limited wide-spread clinical usage. To overcome this limitation, growth factor gene therapy could be an attractive alternative rather than direct application of factors onto the wound beds. We administered two growth factor DNAs, epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) into a cutaneous wound on diabetic mice. We compared the different characteristics of the healing wounds. METHODS: Streptozotocin was injected intraperitoneally to induce diabetes into C57BL/6J mice. The ultrasound micro-bubble destruction method with SonoVue as a bubbling agent was used for non-viral gene delivery of EGF828 and VEGF165 DNAs. Each gene was modified for increasing efficacy as FRM-EGF828 or minicircle VEGF165. The degree of neoangiogenesis was assessed using qualitative laser Doppler flowmetry. We compared wound size and histological findings of the skin wounds in each group. RESULTS: In both groups, accelerated wound closure was observed in the mice receiving gene therapy compared with non treated diabetic control mice. Blood flow detected by laser doppler flowmetry was better in the VEGF group than in the EGF group. Wound healing rates and histological findings were more accelerated in the EGF gene therapy group than the VEGF group, but were not statistically significant. CONCLUSION: Both non-viral EGF and VEGF gene therapy administrations could improve the speed and quality of skin wound healing. However, the detailed histological characteristics of the healing wounds were different.

An immunohistochemical study on the expressions of caspase-6、-7 during the skin incised wound healing in mice / 中国法医学杂志

Objective To investigate the expressions of caspase-6,-7 during skin wound healing and the applicability of the time-dependent expressions of caspase-6,-7 to determination of the wound age.Method The expressions of caspase-6,-7 were studied in skin incised wound in mice by immunohistochemical SABC method,and the non-incised mouse skin was used as control.Results Expressions of caspase-6,-7 were detectable in polymorphonuclear cells (PMNs) in the wound specimens aged 6h. In the wound specimens aged from 12h to 24h after injury, caspase-6,-7 were identified in a large number of infiltrating PMNs and part of mononuclear cells (MNCs). Afterwards, the MNCs and fibroblastic cells (FBCs) accounted for the most part of the caspase-6,-7-positive cells. Morphometrically, the ratios of the number of the caspase-6,-7-stained PMNs, MNCs and FBCs to total number of the cells in the wounds were evaluated and calculated. The ratios of the caspase-6,-7-positive cells were low in the wound specimens aged from 0h to 3h, and maximized in the wound specimens aged 3 day. Thereafter, the ratios decreased and minimized in the specimens aged 14 day.Conclusion The results suggest that caspase-6,-7 were expressed in neutrophils, macrophages and fibroblasts during healing process of skin incised wound in mice. Caspase-6,-7 may be used as a marker for the wound age determination.

Effect Of Polyphosphate On Skin Wound Healing

A study on expression of E-selectin in the incised skin wound and its stability in rats / 中国法医学杂志

0.05).However,there was significant difference in E-selectin expression among each postmortem stability group of which skin samples were kept at 25℃ degree as compared with the wounded skin at 0h after injury(P

An experimental study on the gene and protein expression of TGF ?_1 and its relationship with the wound age during the healing process of incised wound of rat's skin / 中国法医学杂志

In order to explore the relationship between the expression of TGF ? 1,its receptor and the wound age during the healing process of rats skin incision wound,a preliminary study were performed on the vital skin wound 0 5～168h after injury by using the immunohistochemical and the molecular biological methods.The results were then compared with those of the postmortem skin injury.The results revealed that the expression of the cytokine TGF ? 1 in the epithelial cells were enhanced 0 5h after the antemortem skin incision and the strongest reactions were seen at 24～96h post injury.The expression of TGF ? 1 was also found in the macrophages and the fibroblasts in the granulation tissues.Analysis of the immunoblotting(Western blot)results showed that the peak value of the TGF ? 1 protein was appeared at 168h after the antemortem skin incision and peaked at 96h.TGF ? 1 was detected 0 5～3h after postmorten skin injury by using the immunohistochemical method.No expression of mRNA was found.It is suggested that some regular and characteristic expression of TGF ? 1 in the incised skin wounds were related with the wound age.It might be used for timing of skin wound on rat.

ELECTRON MICROSCOPIC STUDY OF THE CHANGES OF CONNECTIVE TISSUE CELLS DURING THE SKIN WOUND HEALING IN RATS / 解剖学报

Open skin wounds were made in 28 Wistar rats, and the changes of the connective tissue cells were observed by electron microscopy during wound healing. The fibroblasts and macrophages were increased in the early stage, later on the fibroblasts might be transformed into myofibroblasts which became preponderant cells in the wound gradually and led to wound contraction and scar formation. The intercellular substances were phagocytosed by fibroclasts simultaneously. The mast cells were closely apposed to the fibroblasts or myofibroblasts and represented active functions, such as degranulation. Considerably they released the granule contents to the extracellular space and effected the other cells functions. It shows that the cells mentioned above interplay and take part in the wound healing.