Keratinocytes, major component of epidermis, play an important role during all phases of wound healing by signaling and crosstalk to other cells, and by migrating and proliferating to close the wound, ultimately achieving barrier restoration and wound closure. Although this ability of skin to maintain barrier and heal wounds is evolutionary conserved and maintained throughout a lifetime of an organism, it fails due to various underlining issues.
Chronic wounds, such as diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) represent a widespread unmet clinical challenge and major burden on healthcare systems worldwide. Epithelialization is also impaired in these patients. Details of biological functions of keratinocytes during healthy and chronic wound healing will be reviewed. Finally, different approaches to restore keratinocyte biological function and epithelialization capacity in chronic wounds will be discussed.
A comprehensive understanding of the epithelialization process will provide new tools for clinical approaches to facilitate epithelial wound closure.