General Medical Information

Fetal Wound Healing

David J. Terris

It seems natural to understand and ultimately exploit the scarless healing that occurs with fetal wounds. In fact, the fetal fibroblast has been confirmed to be the primary cell responsible for such impeccable healing. One study suggested that the cytokine milieu plays a role in scarless fetal wound healing by finding that the presence of TFG-b led to scarred wounds, whereas this cytokine was absent in fetal scarless wounds. Still others have speculated that there are new as yet uncharacterized factors secreted by these cells that result in the scarless healing. It is possible that these factors may someday be identified and genetically engineered and their use may lead to the ultimate goal of scarless wound healing.
Finally, a time-honored tradition in the management of open wounds is the topical application of Dakin’s solution (0.25% sodium hypochlorite). The chemical debridement of the wound and antimicrobial activity achieved by this solution were recognized as early as 1915, when it was introduced by Dakin. Its use was popularized by Nobel Prize laureate Alexis Carrel during World War I. Despite concern for potential toxicity to normal tissues, wet-to-dry dressings with Dakin’s solution remain a popular alternative to saline-soaked dressings, particularly for contaminated or necrotic wounds.