![]() Macrophages become the predominant cell type around 2 to 3 days and have a decisive role in managing the next step of the inflammatory process by either releasing anti-inflammatory cytokines and growth factors signaling resolution of inflammation and progression of wound healing to the proliferative phase, or by releasing inflammatory cytokines that recruit additional neutrophils and prolong the inflammatory process, causing damage to viable tissue and eventually causing a chronic wound. Neutrophils are the dominant cell type around 24 hours, and then undergo apoptosis after resolution of inflammatory stimuli. These neutrophils have an important role in phagocytosis of necrotic tissue and killing of bacterial pathogens. After this initial period, vasodilation and increased vascular permeability leads to localized edema and an influx of important inflammatory mediators, which through chemotaxis, cause neutrophil transmigration to the wound site. 2 This causes platelet aggregation and formation of the fibrin-platelet plug, which not only provides hemostasis, but also provides a platform for the progression of wound healing. In the first few seconds to minutes after a wound occurs, the body instantaneously responds with vasoconstriction and activation of the coagulation cascade. The first phase of wound healing, commonly referred to as the inflammatory stage, spans the first 3 to 5 days of healing. To understand and treat a scar, fundamental knowledge of the timeline of wound healing is of critical importance. 1 A multitude of growth factors and inflammatory mediators secreted by numerous cell lines play crucial and specialized roles in the healing process, such as angiogenesis, fibroblast proliferation, and wound contraction. ![]() Our current understanding of wound healing goes beyond simply categorizing the process into its three stages: inflammation, proliferation, and remodeling. Therefore, each patient should receive a personalized treatment regimen to optimize scar management. ![]() Although numerous treatments exist, no single modality has been proven superior over others. In this article, the authors review the available options in postoperative scar management, addressing the benefits of multimodal perioperative intervention. With that said, preoperative interventions, such as lifestyle modifications and optimization of medical comorbidities, and intraoperative interventions, such as adherence to meticulous operative techniques, are equally important for ideal scarring. These products attempt to create an ideal environment for wound healing by targeting the three phases of wound healing: inflammation, proliferation, and remodeling. Numerous products are available that claim to decrease postoperative scar formation and improve wound healing. Postoperative scar appearance is often a significant concern among patients, with many seeking advice from their surgeons regarding scar minimization.
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