Furnishing Wound Repair by the Subcutaneous Fascia

The review discussed the critical role of subcutaneous fascia in wound healing, emphasizing its unique ability to mobilize into wounds and form a provisional wound scar. Unlike the immobile dermal matrix, the fascia contains essential components like extracellular matrix, fibroblasts, blood vessels, macrophages, and nerves for initial wound repair. Engrailed-1 lineage positive fibroblasts (EPFs) orchestrate this mobilization, and their genetic ablation in mice led to delayed healing, highlighting their importance. The study supported Harris's fibroblast traction theory, showing that fascial EPFs act as conveyor belts to plug wounds. Clinical practices using fascial flaps demonstrated its beneficial role, and fascia abnormalities were linked to pathological fibrosis. Understanding fascia's role could lead to new therapeutic strategies for wound healing and fibrosis.