An Introduction to the Regulation of Wound Healing by Micromechanical Forces

Mechanical forces influence cellular organisation and behaviour. Without mechanical
stimuli, cells stop proliferating and migrating, undergo cell-cycle arrest and eventually
die. Mechanical cues, therefore, have fundamental effects on wound healing. A literature
review was conducted to explore the effects of micromechanical forces and tissue
reactions at a microscopic level on wound healing, and how these forces may be harnessed
in wound care. It is clear from research from a range of databases, chiefly on non-wound
tissues, that micromechanical forces can have a significant influence on tissue growth
and function. When applied to wound healing, it can be deduced that these forces alter
cell proliferation and differentiation, and affect cytokine release and matrix protein
secretion. In contrast to healing wounds, the structural requisites for the transduction
of mechanical cues are lacking in chronic wounds. The absence of extracellular matrix
and the accumulation of wound fluid can lead to the formation of ‘dead space’, across
which mechanical stimuli cannot be transferred. It is suggested that application of
micromechanical forces to chronic wounds — either by negative pressure wound therapy
or specially designed dressings — will promote wound healing by induction of appropriate
microdeformation and that further research is needed in this area.