Skin wound healing: The critical role of angiogenesis

Management of skin wounds is of great clinical importance. Inducing the formation of new blood vessels (angiogenesis) can accelerate the healing process in patients suffering from acute and chronic wounds (e.g., burns and diabetic ulcers). It is currently accepted that angiogenesis plays a substantial role in all four overlapping phases of normal wound healing, that is, hemostasis, inflammation, proliferation, and remodeling. Many experimental studies have focused on the design and development of skin replacements capable of stimulating neovascularization within the skin defect regions. The use of stem/progenitor cells and bioactive molecules (e.g., growth factors and cytokines) in combination with three-dimensional (3D) scaffolds are among the most promising applied strategies for promoting angiogenesis, and subsequently accelerating wound healing. Each approach has its own pros and cons for managing skin wounds. In the present chapter, we first describe the physiology of skin tissue, and the diseases and disorders which affect wound healing. We then summarize current therapies with a focus on tissue-engineering (TE) approaches.