Why does the body create inferior tissue (scars) to heal wounds?

I’m working on a short story that involves scars and have reading a bit about them and am curious to know why the body forms a weaker tissue structure than it is obviously capable of. I’ve read that the collagen is laid down in parallel lines rather than a basket weave like matrix and I’m curious to know why that would be. Why not just make it like healthy skin? What is the trade off - speed? Thanks!

I vaguely remember from biology getting the explanation that it was a case of the body trying to repair itself as quickly as possible - sealing the wound off permanently being the important thing rather than flexibility or durability or appearance.

I also remember that it’s an entirely different type of tissue than skin, and there was research into developing treatments that encouraged “normal” tissues to grow back instead of scar tissues. This one lady spent SEVEN WEEKS growing back the tip of her pinky finger (and it’s still shorter than it was) by debriding it and applying some specialized treatment powder. :eek:

http://www.cnn.com/2010/HEALTH/09/09/pinky.regeneration.surgery/

Scar tissue also has to replace a lot of other kinds of tissue, not just skin. You can have internal scars, too.

Speed in getting the wound closed up is part of it (to reduce the risk of infection, further injury to the weakened area, infestation by flesh-eating maggots, etc.), but another part is that certain tissues regenerate more easily than others.

In the specific case of skin, the epidermal layer (most superficial) regenerates pretty well; since the top layer of cells on your skin is constantly being shed, the epidermis is pretty much revved up for making more cells all the time anyway. The dermis layer underneath, on the other hand, regenerates poorly if at all; if you only lose the epidermis, than if the wound is small enough to heal over quickly you can have little or no scarring, but if the wound is deep enough to cut away any significant amount of dermis you will have a sunken, more thinly-covered area even if the epidermis heals over the wound nicely.

You can see a non-wound example in stretch marks; in this case the dermis pulls apart, leaving a gap, and although the epidermis is stretchy enough to cover the gap without tearing, the skin over the area will be forever thinned out because it’s just epidermis with no dermis underneath.

While on the subject of scars, I was told after gallbladder surgery, that I had a lot of internal scar tissue. That surgery was the only time I’ve had surgery on my torso. Why would someone have scar tissue with no surgery?

It could be your round ligament and falicorm ligament.

These are the remains of your umbilical cords connection - the umbilical vein - which was passing right past your gall bladder.

https://en.wikipedia.org/wiki/Round_ligament_of_liver
https://en.wikipedia.org/wiki/Falciform_ligament

https://en.wikipedia.org/wiki/Umbilical_vein

I dont know why it scarred. … Were you born premature ? Maybe it just happens in some people.

I don’t remember all the medical terms but the the basis of scar tissue is formed by platelets trying to close a breech in normal tissue. Platelets release their “juice” when they encounter raw protein like a fresh cut and the remaining dead platelet bodies form a filler material. Or they collect in the area of a healing infection. The platelets amass in a random fibrous pattern which becomes the pattern of the scar cells.

Consider; a clean cut that is pulled back together accurately heals with almost no scar. That’s because platelets and leaking cellular juices don’t have to bridge some random interface to “stick” the sides of the cut together so there is very little random cell structure.

Internal scarring can occur when muscle (or any other, I’d guess) tissue is torn.

Every tissue (group of cells) is laid on a “scaffold”(basement membrane). In the skin, the main scaffold is between epidermis and dermis. When you get a cut or wound or injury, if you do not break the scaffold, many tissues regenerate without scars. Like the skin mentioned above. If the scaffold is cut, the amount of scarring depends on how big is the scaffold gap. That is the goal of suturing, to close the gap and keep the scaffold as intact as before.

If the gap or injury is too big, it is repaired by cells that lay out collagen, but these cells also contract and pull the fibers together to close the gaps.

Surgery is a common cause, but if you had an internal infection (or even just significant inflammation) within your peritoneal cavity (the space where all your guts sit), you may develop scars (ususally called “adhesions”) that will often bridge between bowel loops and stuff. This infection or inflammatory process probably felt bad at the time, but you may have 'toughed it out" and have maybe even forgotten it.

Now that you bring it up, I did have a lot of stomach area pain when I was about 14 or so. It would take me to my knees just for a minute then let up until the next time. The next time could be 5 min. or 2 days later. Thanks for the answers.

I hope you get other doctor point of view and don’t have unnecessary surgery just because the doctor wants to make profit of you having unnecessary surgery because you have scar tissue. Where you may have had some injury or infection or not.

There lot of crazy doctors pushing unnecessary surgery these day to make a profit.

From his post, it sounds like he’s already had surgery, for his gallbladder. Afterward, his surgeon mentioned it. It probably made his job harder than it would have been otherwise.

As far as I know, no one (crazy or otherwise) is generally recommending abdominal surgery for adhesions (scars). It’s more likely to sway a treatment plan away from surgery, when possible.