Myofibroblasts in head and neck surgery. An experimental and clinical study

Myofibroblasts in human granulation tissue have many of the structural and functional characteristics of smooth-muscle cells and appear to be responsible for wound contraction. They have also been identified in contracted scar tissue in nongranulation wounds. In this report, their role in head and neck wound healing will be explored utilizing transmission electron microscopy and immunoperoxidase techniques with antibodies to the intermediate filament vimentin and to muscle-restricted actins. In piglets, high-tension, low-tension, and granulating wounds were created and studied with serial biopsy specimens. Results showed few myofibroblasts in either the high- or low-tension wounds and multiple myofibroblasts in the granulating wounds. In the clinical studies, the immunoperoxidase technique with monoclonal antibody to muscle-specific actins proved most useful in identifying myofibroblasts. Myofibroblasts were present in granulating wounds and hypertrophic scars. They were not widely present in mature keloids.