The epithelialisation phase in wound healing: options to enhance wound closure.

This review highlights epithelialisation and therapeutic options to optimise and speed the epithelialisation process. To influence this process therapeutically, it is important for clinicians to understand the underlying principles of epithelialisation. The role of growth factors and the hostile local wound environment can explain why epithelial wound closure is so difficult to speed up in some chronic wounds. Clinicians should be aware of the different surgical techniques of skin grafting and more advanced technologies, such as skin substitutes, as options for wounds which fail to respond to standard protocols. Finally, novel dressing-based concepts are discussed, including macromolecular crowding, a concept which aims at boosting growth factor activities produced in the wound space once wound healing is normalised and underway.