Collagen synthesis and remodeling are critical

• FGF, made by macrophages, stimulates fibroblasts

• at confluence, fibroblasts stop dividing

• fibroblasts secrete tropocollagen, a precursor of collagen

• tropocollagen polymerizes outside the cells to form collagen

• collagen polymers are dissolved by collagenases made by macrophages. this remodeling can proceed for a year, and the collagen fibers that do persist are aligned in the direction of most stress

• so repetition of this process causes collagen fibers to line up along lines of stress

• new collagen configuration attains about 80% strength of original and is never as flexible

• protein deficiency delays the rate of collagen synthesis

• vitamin C deficiency reduces the total strength of the scar

Category: Pathology Notes