WOUND HEALING

WOUND HEALING

1. WOUND: disruption of normal structure and function

   • HEALING: results in restoration and function

2. CONDITIONS REQUIRED FOR HEALING

   • Good nutritional status
     • Good general health, free from systemic disease
       • Good blood supply to provide, nutrition, oxygen and waste removal
         • Freedom from contamination of toxins and foreign bodies
           • Infection, immunosuppression, cancer, reduced blood supply impair healing

3. HEALING BY PRIMARY INTENTION

   • Simple, rapid process in a clean skin wound
     • Damaged edges are in close proximity
       • Damage is minimal

4. 3 STAGES IN REPAIR PROCESS:

   • INFLAMMATION: haemostasis, platelets aggregate and form fibrin clot
     • Inflammatory phase, bacteria phagocytosed, clot infiltrated by PMN's
       • Cytokines released, cause migration and division of cells
   • PROLIFERATION: fibroblasts enter site
     • Angiogenisis: new blood vessels form when endothelial cells migrate
       • Collagen deposition and granulation tissue formation:
         • Fibroblasts lay down collagen matrix
           • Granulation tissue consist of new blood vessels+inflam cells
             • Epithelialisation:, e cells migrate to wound edges
               • Contraction: Myofibroblasts make wound smaller by contracting
   • MATURATION AND REMODELLING
     • Granulation tissue replaced by fibrous scar
       • arranging of collagen fibres for strenght
         • vascularity reduces, cells removed by apoptosis