Remodeloitumisvaihe

Remodeloitumisvaihe, or the remodeling phase, is the final stage of wound healing and tissue repair. It follows the initial inflammatory and proliferative (repair) phases and can continue for weeks to months, depending on the tissue involved and the extent of injury. During this phase, the newly formed tissue is reorganized and strengthened to approach its original structural integrity.

The key processes in remodeling involve the maturation of the extracellular matrix, especially collagen. Collagen type III laid down in the early repair phase is gradually replaced by collagen type I, and cross-linking increases, improving tensile strength. Fibroblast activity declines as the tissue becomes more organized, and capillary density decreases as granulation tissue regresses. Collagen fibers realign along lines of mechanical stress, contributing to functional recovery and a scar that is typically flatter and less pliable than unwounded tissue.

Functional outcomes vary by tissue. In skin, tensile strength rises gradually and may reach roughly 70–80% of intact skin over several months, but scars rarely regain full strength. In bone, remodeling restores microarchitecture through coordinated osteoclast and osteoblast activity, replacing a temporary callus with a mature bone pattern over a longer period. Tendons and other connective tissues also undergo gradual remodeling, which can influence elasticity and resilience.

Several factors influence remodeling quality and duration. Adequate nutrition and perfusion, absence of infection, and controlled mechanical loading promote better outcomes. Adverse factors include aging, smoking, diabetes, nutritional deficiencies, corticosteroid use, and excessive early movement or tension on the wound. Proper scar management and rehabilitation can help minimize contractures and hypertrophic scars during this phase.