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Cited by 78Dermatologic Treatments and ResearchWound Healing and TreatmentsCellular Mechanics and Interactions

Skin biomechanics: a potential therapeutic intervention target to reduce scarring

Open access
Hosseini, Motaharesadat, Brown, Jason, Khosrotehrani, Kiarash, Bayat, Ardeshir, Shafiee, Abbas·2022·Burns & Trauma
DOI 10.1093/burnst/tkac036PMC PMC9398863
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Abstract

Pathological scarring imposes a major clinical and social burden worldwide. Human cutaneous wounds are responsive to mechanical forces and convert mechanical cues to biochemical signals that eventually promote scarring. To understand the mechanotransduction pathways in cutaneous scarring and develop new mechanotherapy approaches to achieve optimal scarring, the current study highlights the mechanical behavior of unwounded and scarred skin as well as intra- and extracellular mechanisms behind keloid and hypertrophic scars. Additionally, the therapeutic interventions that promote optimal scar healing by mechanical means at the molecular, cellular or tissue level are extensively reviewed. The current literature highlights the significant role of fibroblasts in wound contraction and scar formation via differentiation into myofibroblasts. Thus, understanding myofibroblasts and their responses to mechanical loading allows the development of new scar therapeutics. A review of the current clinical and preclinical studies suggests that existing treatment strategies only reduce scarring on a small scale after wound closure and result in poor functional and aesthetic outcomes. Therefore, the perspective of mechanotherapies needs to consider the application of both mechanical forces and biochemical cues to achieve optimal scarring. Moreover, early intervention is critical in wound management; thus, mechanoregulation should be conducted during the healing process to avoid scar maturation. Future studies should either consider combining mechanical loading (pressure) therapies with tension offloading approaches for scar management or developing more effective early therapies based on contraction-blocking biomaterials for the prevention of pathological scarring.

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Crossref · 10.1093/burnst/tkac036

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  • Mice and pigs have critical differences in skin morphology and disease processes from human skin, complicating research translation.

    “Furthermore, human skin models are necessary to reduce the reliance on animal models such as mice and pigs, where the skin morphology and disease processes have critical differences from that of human skin, complicating research translation [1, 2].”

    From The empowering influence of air-liquid interface culture on skin organoid hair follicle development (2025) · cites this paper as [2]

    The Review’s ‘Emerging therapeutic approaches’ section describes mouse and pig models, and notes a human-like scarring phenotype in a pig model. Our copy does not say that mice and pigs have critical differences in skin morphology or disease processes that complicate translation to humans (searched for species differences, animal-model limitations, and translation). (LLM, conf=0.72)

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Cites

1 retracted

Flagged first, then by citations

4 of the 143 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Katz, 1992, Silastic gel sheeting is found to be effective in scar therapy, Cosmet Dermatol., 6, 1

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Authors
Hosseini, M., Brown, J., Khosrotehrani, K., Bayat, A., & Shafiee, A.
Affiliations
  • Queensland University of Technology (AU)
  • Queensland Health (AU)
  • Translational Research Institute (AU)
  • University of Cape Town (ZA)
Corresponding author
Shafiee, Abbas
ORCID
Venue
Burns & Trauma
Publisher
Oxford University Press (OUP)
Published
2022-01-01
Volume
10
Pages
tkac036-tkac036
ISSN
  • 2321-3868 (ISSN-L)
  • 2321-3876
DOI
10.1093/burnst/tkac036
PMC
PMC9398863
OpenAlex
W4293024091
Semantic Scholar
cd82a3d0de3880192df655e2f228af4c6960fb70
Cited by
78
References
143
Citations by year
2026: 26 · 2025: 21 · 2024: 19 · 2023: 10 · 2022: 2
FWCI
2.31
Type
journal article
Language
en
Open access
Licence
Locations
  • Burns & Trauma (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Metro North Hospital and Health Service
Topics
  • Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
  • Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Cellular Mechanics and Interactions
Keywords
skin biomechanics, pathological scars, keloids, hypertrophic scars, mechanotransduction, mechanotherapy, wound healing, myofibroblasts, fibroblast differentiation, wound contraction, mechanical loading, scar prevention

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