Fetal wound healing.

Multiple distinctions concerning the adult and fetal wound healing processes exist. In the fetus, a minimal inflammatory response to wounding is seen with a marked deposition of glycosaminoglycans, particularly hyaluronic acid. Collagen seems to be present in small amounts and is rapidly and efficiently organized into structural nonscarred tissue components, a process that seems to be uniquely influenced by the ECM and its components. The exact mechanisms of control of growth, development and healing in the fetus are unclear, although a transition from fetal to adult processes takes place in utero. Furthermore, some processes may, in part, transiently reappear in healing wound found in adults. Clearly, there is a vast horizon for future investigation. The concept of fetal surgical treatment has become a reality. Many observations made in this field may well be applied in future attempts to prevent pathologic healing, and may even yield wounds far superior to the predicted "normal" results we see today. The future of wound manipulations may involve the crafting of complex matrices interwoven with a variety of cytokinetic agents, which could result in a healed wound or regenerated tissue that is mechanically and functionally equivalent to adjacent unwounded tissue. Furthermore, if the secrets of fetal healing can be revealed, areas of clinical intervention may be expanded to aid in controlling other abnormal patterns of tissue growth observed in clinical medicine as well.