Cutaneous wound healing is a complex and orchestrated biological process that comprises multiple coordinated events aimed at restoring tissue integrity. This phenomenon progresses through distinct yet overlapping phases, which include hemostasis and inflammation, proliferation, and remodeling1. The inflammatory phase begins minutes after wound formation, peaks between 24 and 48 h post-injury, and involves the recruitment of immune cells and the release of inflammatory mediators. The proliferative phase is marked by re-epithelialization and granulation tissue formation, starting 4 to 5 days post-injury and potentially lasting for weeks. Finally, the wound enters the remodeling phase, which begins in the third week post-injury and can extend for months or years, being characterized by tissue reorganization2. When healing fails to progress normally, it can result in a chronic wound, which poses a significant burden on both the patient and the healthcare system3, underscoring the need to develop novel therapeutic approaches.
The creation of an excisional wound via the surgical removal of all skin layers (epidermis, dermis, and subcutaneous tissue) from the animal allows for the investigation of inflammation, granulation tissue formation, re-epithelialization, angiogenesis, and the remodeling process4. Over recent decades, the adoption of wound-healing models has enabled numerous discoveries, expanding the knowledge and understanding of the molecular and cellular events that facilitate this process5. In vivo models remain the most predictive tools for studying human wound repair, as they more accurately represent the complete healing microenvironment due to the presence of multiple cell types, environmental cues, and paracrine interactions6. In this context, rats and mice are widely utilized due to their ease of handling and maintenance4.
In these models, punch biopsies are frequently used to induce surgical wounds because they provide standardized excisions. Consequently, most experimental models described in the literature are based on the establishment of circular lesions7—12. Although this approach is widely accepted, the use of alternative geometries can diversify the methodological approaches available for wound healing studies. In this regard, creating wounds with a scalpel enables the generation of lesions of varying sizes and in defined shapes outside the standard circular pattern used in punch biopsies13,14,15,16,17,18. Furthermore, comparative studies in animal models have demonstrated that scalpel incisions inflict less initial tissue damage compared to other techniques19.
This protocol describes an alternative surgical methodology for inducing full-thickness excisional skin wounds in rats, using a square lesion model on the flank. The presented approach facilitates the standardization of the lesion area and the monitoring of the tissue repair process. Furthermore, it is applicable to studies aiming to evaluate the effects of different therapeutic strategies and biomaterials throughout the distinct stages of cutaneous healing under physiological or pathological conditions.