52428
WOUND HEALING 2
- HEALING BY SECONDARY INTENTION
- When there's on going tissue damage from infection
- Significant tissue loss where edges of wound cannot be brought together
- Granulation tissue formed
- Scar contraction greater + re epithelisation less
- Scar contraction greater + re epithelisation less
- Granulation tissue formed
- Significant tissue loss where edges of wound cannot be brought together
- When there's on going tissue damage from infection
- INFLAMMATION
- separation of necrotic tissue: phagocyte action within exudate
- Necessary part of healing: clearing debris and inducing proliferation
- Lasts as long debris is in the wound
- Lasts as long debris is in the wound
- Necessary part of healing: clearing debris and inducing proliferation
- separation of necrotic tissue: phagocyte action within exudate
- PROLIFERATION
- begins as granulation tissue: new capillary buds, phagocytes and fibroblasts
- Reaches dermis epithelial cells, proliferates from edges to centre
- Formation of granulation tissue is essential in open wound
- Epithelial cells migrate across new tissue to form a barrier
- Epithelial cells migrate across new tissue to form a barrier
- Formation of granulation tissue is essential in open wound
- Reaches dermis epithelial cells, proliferates from edges to centre
- begins as granulation tissue: new capillary buds, phagocytes and fibroblasts
- MATURATION AND RE-MODELLING
- Granulation tissue replaced by scar tissue
- scar tissue: increase in extracellular collagen, inflame cells dissapear
- collagen matures and contracts
- collagen matures and contracts
- scar tissue: increase in extracellular collagen, inflame cells dissapear
- Granulation tissue replaced by scar tissue
- GRANULATION TISSUE
- Commonly seen with fresh healing tissue
- Macroscopically appear as red granular areas which bled easily
- fragile newly formed capillaries which proliferate and grow
- contains chronic inflam cells
- contains chronic inflam cells
- fragile newly formed capillaries which proliferate and grow
- Macroscopically appear as red granular areas which bled easily
- Commonly seen with fresh healing tissue
- SCAR FORMATION/FIBROSIS
- Forms when there is a large area of tissue damage
- cells do not regenerate due to ischemia, suppuration
- starts with granulation tissue the inflam material is removed
- Only collagen fibres remain
- Only collagen fibres remain
- starts with granulation tissue the inflam material is removed
- cells do not regenerate due to ischemia, suppuration
- Forms when there is a large area of tissue damage
- EFFECTS OF SCAR TISSUE
- ADHESIONS: may limit movement
- FIBROSIS: blockage of an end vessel
- SHRINKAGE: as fibrous tissue ages, limited movement
- SHRINKAGE: as fibrous tissue ages, limited movement
- FIBROSIS: blockage of an end vessel
- ADHESIONS: may limit movement
- FACTORS INFLUENCING HEALING
- LOCAL: persisting infection, foreign mat, or stimuli
- Poor blood supply
- Irradiation
- Locally applied drugs, corticosteroids
- Irradiation
- Poor blood supply
- SYSTEMIC: age and nutrition
- metabolic disease ie diabetes
- Malignancies
- Malignancies
- metabolic disease ie diabetes
- LOCAL: persisting infection, foreign mat, or stimuli
- DENTAL EXTRACTIONS
- healing by Secondary Intention as there is wide separation
- PHASES OF WOUND HEALING
- INFLAM PHASE: coagulation provides clot, provides initial tissue for migration of cells
- Platelet plug and secret mediators that attract macrophages and fibroblasts
- PROLIFERATION PHASE: fibroblasts +endo cells from remains of perio membrane
- MATURATION REMODELLING: woven bone is remodelled
- formation of cortical and cancellous bone
- reduction of height in alveolar bone. Site healed in 20-30 weeks
- reduction of height in alveolar bone. Site healed in 20-30 weeks
- formation of cortical and cancellous bone
- MATURATION REMODELLING: woven bone is remodelled
- PROLIFERATION PHASE: fibroblasts +endo cells from remains of perio membrane
- Platelet plug and secret mediators that attract macrophages and fibroblasts
- INFLAM PHASE: coagulation provides clot, provides initial tissue for migration of cells
- PHASES OF WOUND HEALING
- healing by Secondary Intention as there is wide separation
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