[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Tissue repair](https://durgical.com/en/general-pathology/#a-repair) › Tissue repair: regeneration or scar; labile, stable and permanent cells

[General pathology](https://durgical.com/en/general-pathology/) · [Tissue repair](https://durgical.com/en/general-pathology/#a-repair)

# Tissue repair: regeneration or scar; labile, stable and permanent cells

- Topic

Damaged tissue heals either by growing back the same cells or by filling the gap with a scar; which one depends on the cells and the framework.

Updated 2026-11-01

## Key points

- Labile = always dividing (skin, gut, marrow); stable = resting in G0, divide when needed (liver, kidney tubules); permanent = neurons, cardiomyocytes.
- Regeneration requires dividing cells and an intact matrix framework.
- Permanent tissue heals by scar (heart) or by gliosis (brain).
- Most repair = regeneration + scar in varying proportions.

## What it is

Repair restores tissue after injury in two ways. Regeneration replaces lost cells with cells of the same type and restores normal structure; it needs cells that can divide and an intact extracellular matrix framework. Scar formation fills the defect with collagen; it restores continuity but not function. Most repairs combine both, and the balance depends on the type of cells, how severe the injury is and whether the framework survived.

## Key facts

- Regeneration needs intact extracellular matrix: the basement membrane gives cells a template to rebuild the original architecture.
- If the framework is destroyed (abscess, infarct, severe necrosis), even regenerating organs heal with scar: cirrhosis has nodules separated by fibrous bands.
- Growth factors drive repair: EGF and TGF-α (epithelia), HGF (hepatocytes), VEGF (vessels), PDGF and FGF (fibroblasts), TGF-β (collagen, fibrosis).
- In the brain, dead tissue is cleared by macrophages (liquefactive necrosis) and the gap is lined by astrocytes (gliosis), not collagen.

## Proliferative capacity of tissues

| Group | Behaviour | Examples |
| --- | --- | --- |
| Labile (continuously dividing) | Lost cells are constantly replaced from stem cells | Epidermis; epithelium of the gut, mouth, cervix and ducts; bone marrow |
| Stable (quiescent) | Rest in G0 but can divide after injury or loss of mass | Hepatocytes, renal tubular cells, pancreas, fibroblasts, endothelium, smooth muscle |
| Permanent (non-dividing) | Do not divide meaningfully; injury heals by scar (heart) or glial scar (brain) | Neurons, cardiomyocytes; skeletal muscle has limited repair through satellite cells |

## Clinical notes

- A myocardial infarction always ends in a collagen scar because cardiomyocytes are permanent cells.
- Acute tubular injury in the kidney can recover fully because tubular cells regenerate on an intact basement membrane.
- Bone, mucosae and liver can regenerate almost completely when the framework is preserved.

## Memory aid

Labile cells are a relay team, always handing over; stable cells are reservists, called up when needed; permanent cells have retired and leave only a scar.

## Test yourself

Think of the answer, then tap the question to see it.

## Why does a myocardial infarct heal with a scar?

Cardiomyocytes are permanent cells that cannot divide meaningfully, so dead muscle is replaced by granulation tissue and then collagen.

## Hepatocytes are stable cells, yet cirrhosis is full of scar. Why?

Repeated injury destroys the reticulin framework and drives fibrosis, so regeneration forms disorganised nodules surrounded by fibrous septa.

## Which tissues are made of labile cells?

Epidermis, gastrointestinal epithelium, bone marrow, epithelium of the cervix and urinary tract.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/tissue-repair-regeneration-or-scar-labile-stable-and-permanent-cells/)

## Related

- [Granulation tissue and scar formation](https://durgical.com/en/general-pathology/granulation-tissue-and-scar-formation/)
- [Liver regeneration](https://durgical.com/en/general-pathology/liver-regeneration/)
- [Fibrosis in organs: TGF-β and the myofibroblast](https://durgical.com/en/general-pathology/fibrosis-in-organs-tgf-and-the-myofibroblast/)
- [Healing of skin wounds: first and second intention](https://durgical.com/en/general-pathology/healing-of-skin-wounds-first-and-second-intention/)
- [Outcomes of acute inflammation: resolution, abscess, scar or chronic inflammation](https://durgical.com/en/general-pathology/outcomes-of-acute-inflammation-resolution-abscess-scar-or-chronic-inflammation/)
- [Hyperplasia: physiologic and pathologic](https://durgical.com/en/general-pathology/hyperplasia-physiologic-and-pathologic/)

## Related conditions

- [Myocardial Infarction (Heart Attack)](https://durgical.com/en/conditions/myocardial-infarction/)
- [Cirrhosis](https://durgical.com/en/conditions/cirrhosis/)
- [Ischaemic stroke](https://durgical.com/en/conditions/ischaemic-stroke/)
- [Acute kidney injury](https://durgical.com/en/conditions/acute-kidney-injury/)
- [Viral hepatitis](https://durgical.com/en/conditions/viral-hepatitis/)
- [Burns (thermal, chemical, electrical; inhalation injury)](https://durgical.com/en/conditions/burns/)
- [Chagas cardiomyopathy](https://durgical.com/en/conditions/chagas-cardiomyopathy/)

## Elsewhere in DurgiPedia

- [Stem cells and tissue renewal: labile, stable and permanent tissues](https://durgical.com/en/histology/stem-cells-and-tissue-renewal-labile-stable-and-permanent-tissues/)
- [Cell cycle, mitosis and meiosis](https://durgical.com/en/histology/cell-cycle-mitosis-and-meiosis/)
- [Extracellular matrix: collagen types, elastin, ground substance](https://durgical.com/en/histology/extracellular-matrix-collagen-types-elastin-ground-substance/)
- [Wound healing: phases and scar](https://durgical.com/en/histology/wound-healing-phases-and-scar/)
- [Liver: lobule, acinus, hepatocytes, sinusoids, Kupffer cells](https://durgical.com/en/histology/liver-lobule-acinus-hepatocytes-sinusoids-kupffer-cells/)

[← All of general pathology](https://durgical.com/en/general-pathology/)

Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [4.6 Tissue Injury and Aging](https://openstax.org/books/anatomy-and-physiology-2e/pages/4-6-tissue-injury-and-aging) (OpenStax (Anatomy and Physiology 2e), 2022); [23.6 Accessory Organs in Digestion: The Liver, Pancreas, and Gallbladder](https://openstax.org/books/anatomy-and-physiology-2e/pages/23-6-accessory-organs-in-digestion-the-liver-pancreas-and-gallbladder) (OpenStax (Rice University), 2022); [Cirrhosis: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000255.htm) (MedlinePlus, US National Library of Medicine, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/general-pathology/tissue-repair-regeneration-or-scar-labile-stable-and-permanent-cells/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/tissue-repair-regeneration-or-scar-labile-stable-and-permanent-cells/