During the final phase of the wound healing process tensile strength of the wound increases, while at the same time contraction of the wound begins to finally repair the defect.  In most cases this process occurs through the formation of scar tissue.  Scar tissue is an acceptable outcome for wound healing but is associated with a decrease in tensile strength having approximately 80% strength of normal regenerated skin.  The trigger for the initiation maturation is when collagen production and degradation reach an equilibrium, at this point the maturation phase begins,replacing provisional type III collagen performed during the proliferative phase with type I collagen.  This takes a disorganized collagen structure and rearranges and cross-links the fibers along tension lines forming a more durable, strong and organized closure.

Assuming all of the phases of wound healing progress in a predictable manner tissues regenerated with good tensile strength.

As we’ve seen over the past several articles regarding the phases of wound healing this is a complex both cellular and chemical process which occurs, and any in the process abnormalities in the progress through the phases may lead to an inappropriately healing wound.  Wound fails to progress in a predicted fashion through the phase of wound healing, and in a timely manner the wound is considered to be a chronic wound.