[Physiology of wound healing. Modern approach to wound care]

The wound healing cascade is based on the programmed, reproducible cooperation of the cells involved in reparation, their products, further humoral factors and the intercellular stroma. The author describes the physiological events during the phases of cutaneous acute wound healing by second intention, such as coagulation, inflammation, proliferation, remodelling, takes into account the local pathophysiological processes found in chronic wounds. The author reviews the recent scientific literature on wound healing as well. Information is rapidly growing about the communication between cells and factors involved in cutaneous wound repair. Parallel control of the same step is common among physiological processes, with redundant safety mechanisms. The failure of therapeutic approaches based on single factor substitution is predictable for the clinician, because it is yet impossible to properly orchestrate the introduction of these factors to the system. In case of chronic wounds sofar the most effective intervention into the course of wound healing can be achieved by adding complex live structures, such as in case of biotechnologically derived materials or skin transplantation.