PROBLEMS OF HEALING SOFT TISSUE INJURIES

Introduction. Wound healing is one of the key physiological processes that ensure human survival, and at the same time, it is an urgent medical problem. This literature review presents modern ideas on the repair of soft tissue injuries in normal and in various pathological conditions. Methods. The literature review was based on published scientific studies using the information retrieval systems PubMed, Web of Science, Scopus, Google Scholar, and ResearchGate. We mainly reviewed the studies that were published in the last 5 years. 77 scientific papers were selected for the article. Results. The structure and cellular composition, the role of stem cells of the skin and muscle tissue in the regenerative aspect were analyzed. The histological characteristics of the stages of healing, as well as the effect of some pro-inflammatory and anti-inflammatory interleukins, growth factors, are given. Scientific data indicate that repairing acute wounds is a strictly coordinated process in time and space of the interaction of various cell pools and bioactive molecules. Analysis of experimental and clinical studies also reflects the sensitivity of the healing process to the action of both local and systemic factors. The influence of such factors leads to the transition of acute wounds into chronic ones. Mechanisms of disorders arising from excessive inflammation and synthesis of the extracellular matrix, delay of re-epithelialization are given in the review. The influence of infection, hypoxia, hormonal and dietary disorders, hyperglycemia, venous hypertension, kidney diseases, and tissue compression is highlighted. Conclusions. The skin and underlying muscles are often exposed to injuries and have significant regenerative and repair capabilities. Acute wounds go through a series of successive stages in their healing process, which ensure the restoration of the morphological and functional properties of tissues. Under the influence of various factors acute soft tissue injuries can turn into chronic, long-term wounds. Such wounds are characterized by disturbances in the sequence and duration of healing stages, intercellular and cell-matrix interactions, and the dynamics of regulatory cytokines. Further scientific research on the pathogenesis of chronic wounds will contribute to their more successful treatment.