Wound healing is a complex process that involves the coordinated actions of many different tissues and cell lineages. It requires tight orchestration of cell migration, proliferation, matrix deposition and remodelling, alongside inflammation and angiogenesis. Whereas small skin wounds heal in days, larger injuries resulting from trauma, acute illness or major surgery can take several weeks to heal, generally leaving behind a fibrotic scar that can impact tissue function. Development of therapeutics to prevent scarring and successfully repair chronic wounds requires a fuller knowledge of the cellular and molecular mechanisms driving wound healing. In this Review, we discuss the current understanding of the different phases of wound healing, from clot formation through re-epithelialization, angiogenesis and subsequent scar deposition. We highlight the contribution of different cell types to skin repair, with emphasis on how both innate and adaptive immune cells in the wound inflammatory response influence classically studied wound cell lineages, including keratinocytes, fibroblasts and endothelial cells, but also some of the less-studied cell lineages such as adipocytes, melanocytes and cutaneous nerves. Finally, we discuss newer approaches and research directions that have the potential to further our understanding of the mechanisms underpinning tissue repair.

伤口愈合是一个复杂的过程，涉及许多不同组织和细胞谱系的协调作用。它需要细胞迁移、增殖、基质沉积和重塑以及炎症和血管生成的紧密协调。小皮肤伤口在几天内即可愈合，而外伤、急性疾病或大型手术造成的较大损伤可能需要数周时间才能愈合，通常会留下纤维化疤痕，影响组织功能。开发预防疤痕和成功修复慢性伤口的疗法需要更全面地了解驱动伤口愈合的细胞和分子机制。在这篇综述中，我们讨论了目前对伤口愈合不同阶段的理解，从凝块形成到上皮再形成、血管生成和随后的疤痕沉积。我们强调不同细胞类型对皮肤修复的贡献，重点关注伤口炎症反应中的先天性和适应性免疫细胞如何影响经典研究的伤口细胞谱系，包括角质形成细胞、成纤维细胞和内皮细胞，但也包括一些研究较少的细胞细胞谱系，例如脂肪细胞、黑素细胞和皮肤神经。最后，我们讨论了新的方法和研究方向，这些方法和研究方向有可能进一步加深我们对组织修复机制的理解。