The Healing Process Stages of Healing n n

The Healing Process

Stages of Healing n n n 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 n n Days 1 -4 When a cell is damaged chemicals are released to initiate the inflammatory response

Signs of Inflammation n n Redness (Rubor) Swelling (Tumor) Tenderness (Dolor) Increased Temperature (Calor) Loss of Function (Functio laesa)

Inflammatory Stage Cont. n n n 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 n n During this stage proliferative and regenerative activity lead to the formation of scar tissue Extracellular Matrix consists of: n n n Collagen Elastin Ground Substance Proteoglycons Glycosamenglycans

Maturation Stage n 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 n Extent of the injury n n Microtears- small disruptions in tissue that occur over time (overuse injury) Macrotears- large disruptions in tissue that occur quickly (acute trauma)

Edema and Hemorrhage n Swelling that sits in the injured area retards the healing by n n 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 n n n 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 n n n 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 n 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)