Phases of Wound Healing
A. Hemostasis and Inflammation
B. Proliferation
C. Maturation and Remodelling
Phases of wound healing: precedes inflammation with the ensuing release of chemotactic factors from the wound site
Hemostasis and Inflammation
Are the first infiltrating cells to enter the wound site, peaking agg 24-48 hours
PMNs
PMNs are the major source of cytokines early during inflammation, especially TNF-a, which may have a significant influence on subsequent ___
angiogenesis and collagen synthesis
Second population of inflammatory cells that invades the wound, which are essential to successful wound healing. They achieve significant numbers in the wound by 48-96 hours post-injury and remain present until wound healing is complete
Macrophages
Peak about 1 week post injury and truly bridge the transition from the inflammatory to the proliferative phase of healing
T-lymphocytes
Proliferative phase is th second phaseof wound healing and roughly spans what days?
Days 4 through 12
phases of wound healing: it is during this phase that tissue continue continuity is reestablished.
Proliferation
Last cell populations to infiltrate the healing woud
Fibroblasts and endothelial cells
Strongest chemotactic factor for fibroblast
PDGF
Primary function of fibroblast
Matrix synthesis remodelling
Accumulates in significant amounts in the wound environment overtime, is a potent regulator of collagen synthesis through a mechanism involving ADP- ribosylation
Lactate
Also proliferate extensively during maturation and remodeling phase. These cells participte in the formation of new capillaries
Endothelial cells
Represent a major source of VEGF in the healing wound
Collagen types for wound repair
Type I and III
Type 1- major component of extracellular matrix in skin
Type III- becomes more prominent and important during the repair process
Major glycosaminoglycans present in wounds
Dermatan and chondroitin sulfate synthesized by fibroblasts
Maturation and remodeling phase of he scar begins during fibroplastic change and is characterized by
Reorganization of previously synthesized collagen
Collagen is broken down by
Matrix metalloproteinases
Characteristic pattern of the deposition of matrix at the wound site
Fibronectin and collagen type III constitute the early matrix scaffolding
Glycosaminoglycans and proteoglycans
Collagen type I is the final matrix
Glycoprotein secreted by fibroblasts is essential for the formation of elastic fibers found in connective tissue
Fibrillin
Final step in establishing tissue integrity
Epithelialization
Epithelialization begins within 1 day of injury and is seen as
Thickening of the epidermis at the wound edge
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