Induction of the Fetal Scarless Phenotype in Adult Wounds: Impossible?

Adult cutaneous wounds repair through a fibroproliferative response which results in a scar. Early-gestation fetal skin has the ability to regenerate damaged skin without the formation of a scar in a process that resembles regeneration. The fetal and adult wound healing phenotypes are characterized by differences in the degree of inflammation, molecular signaling, extracellular matrix composition, and biomechanical properties. Significant advancements in understanding scarless fetal mammalian wound healing have led to the development of therapeutic applications with the potential to reduce scarring in the healing of adult cutaneous wounds. This chapter outlines the molecular and cellular processes involved in scarless fetal wound healing and the progress that has been made in recapitulating this process in adult wounds.