Manipulating the healing response

The skin is a fundamental barrier that interfaces with the environment, constituting the first line of defense from physical, chemical, and biological attacks. To counteract the insults multiple and complex pathway systems have evolved and been built up in the skin. Skin injuries, such as wounds, induce a highly dynamic repair program starting from inflammation and moving to tissue formation and maturation, where specific cell-cell and cell-matrix interactions, cytokines, and growth factors, in collaboration, aim to recover its integrity and homeostasis. In this context the inflammatory response plays a key role in directing the outcome of the wound healing response that is otherwise unbalanced in the chronic repair process, especially in patients with diabetes. The management of chronic wounds will be discussed, trying to ameliorate the comprehension of the relationships among the cellular types occurring in the healing process.