Collagen fiber formation in repair tissue: development of strength and toughness.

Dermal repair tissue shows a progressive increase in collagen content which may be related to the wound tensile strength. Wound strength and extensibility are lower than those found in normal skin. In animals, wounds closed by metal clips are chosen as a model to study the proliferative and remodeling phases of healing from a mechanical and morphological point of view. During the proliferative phase the low wound strength is associated with formation of collagen fibers of small diameter, later, (days 28-45) an acute change appears corresponding to the remodeling phase, with increased collagen fiber diameters observed by scanning electron microscopy and light microscopy, and increased tensile strength and toughness. By 180 days, wound strength and collagen fiber morphology were close to that observed in the normal skin. These observations show a direct relationship between collagen fiber diameter and tensile strength. In addition, packing density of collagen fibrils (determined by the birefringence retardation per unit thickness under polarized light) was unchanged until day 90, although collagen fiber diameters increased during this time.