Abstract
The works described provided much of the basis for wound healing as we now
understand it. The important role of the fibroblast in generating fibrotic healing
characteristic of dermal repair and the key part played by the macrophage (Liebovich and Ross in 1975) were among the many advances of the twentieth century.
However, in general, few concerned themselves with or even believed it possible to
do more than to optimize the natural healing process. J. E. Dunphy, surgeon and
scientist, conducted experiments showing that wounds deliberately reopened and
resutured 4-6 days after operation had almost the same tensile strength as a fresh
primary that had not been opened at the end of 1 week. Dunphy’s postulate of a
‘‘wound hormone’’ to explain these findings led to a search for such a wound hormone and suggested the possibility of speeding healing beyond the natural speed.
In 1962, George Winter’s studies of occlusive film treatment of superficial swine
wounds showed that epithelization could be sped by about 30%. This work was
repeated in man by Hinman and Maibach in 1963 showing indeed that in man
epithelization could be sped. David Rovee’s work showing that occlusion improved
scar appearance expanded the concept of controlling wound repair to include dermal
as well as epidermal events. In work conducted in the 1960s that ultimately led to a
Nobel Prize, Stanley Cohen, observed that submaxillary gland extracts injected into
new born mice led to earlier epidermal maturation as manisfested by early eyelid
opening and precocious eruption of the incisors. He ultimately isolated EGF as
the active principle in studies which reignited the search for agents able to act as
‘‘wound hormones.’’