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The Healing Process
Stages of Healing
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Injury
Inflammation Stage (Days 1-4)
Fibroblastic Repair Stage (Day 4 - 6 weeks)
Maturation and Remodeling Stage (2-3 years)
Note: Phases of healing overlap and have no
definitive beginning or end
Inflammatory Stage
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Days 1-4
When a cell is damaged chemicals are released
to initiate the inflammatory response
Signs of Inflammation
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Redness (Rubor)
Swelling (Tumor)
Tenderness (Dolor)
Increased Temperature (Calor)
Loss of Function (Functio laesa)
Inflammatory Stage Cont.
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Chemical mediators (Histamine, leukotrienes,
and cytokines)
Vascular reaction (vasoconstriction,
vasodilation, and exudate creates stasis)
Platelets and leukocytes adhere to the vascular
wall
Phagocytosis
Clot formation
Fibroblastic Repair Stage
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During this stage proliferative and regenerative
activity lead to the formation of scar tissue
Extracellular Matrix consists of:
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Collagen
Elastin
Ground Substance
Proteoglycons
Glycosamenglycans
Maturation Stage
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This process is to take the existing scar tissue
and or calcium growth and smooth it out so it
matches the existing tissue
Factors That Impede Healing
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Extent of the injury
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Microtears- small disruptions in tissue that occur
over time (overuse injury)
Macrotears- large disruptions in tissue that occur
quickly (acute trauma)
Edema and Hemorrhage
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Swelling that sits in the injured area retards the
healing by
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Causing separation of tissue
Inhibits neuromuscular control
Impedes nutrition to the area
This happens even to the smallest injury but
too much has the same effects as edema
Other Factors
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Poor vascular supply
Separation of tissue- smooth edges yield
smaller scars, jagged edges yield an increase in
scar tissue
Muscle spasms
Atrophy
Corticosteroids- Controversial early impedes
healing, late stages up for debate
Other Factors
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Keloids- results because of an increase in collagen
production and a decrease in collagen
absorption/breakdown
Infection- presence of bacteria in the wound delays
healing and increases scarring
Health, Age and Nutrition- increase in age = decrease
in elasticity of skin
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Nutrition is very important- Vitamin A (collagen synthesis
and immune system), Vitamin K (clotting), Vitamin C
(immune system), zinc (enzyme production), and amino
acids (protein restructuring)