**3.4. Stage 4 (remodelling/maturation phase)**

This is the fourth and final stage of wound healing and it might extend up to 2 years from the time of tissue trauma. During this stage, the raised and reddish scar becomes more flat, smooth and lighter in colour. This relates to a reduction in the blood supply. Mature scars are hairless, avascular and do not contain sweat or sebaceous glands.

Collagen fibres are reorganised to maximise tensile strength, a process called remodelling and it is stimulated by macrophages [8].

Hypertrophic scar and keloid formation are two known abnormalities associated with this stage. While the former takes place after initial repair, the latter occurs sometime after healing is completed and continues to grow afterwards [9]. Keloid formation occurs 10 times more commonly in the Black Afro-Caribbean population in comparison to Caucasian population [9] **Table 1**.
