The Healing Process By: John Delia

Inflammation Phase 3 Responses –Vascular –Cellular –Immune Collective Function: Reduce microorganisms, dead tissue, and any foreign materials

Vascular Response First Response (Initial 5-10 mins) –Transient vasoconstriction with area’s vessels to allow platelets into area to begin clotting Second Response –Chemical events cause vasodilatation, to produce an area of cell rich blood, allowing the area to be flushed out How do we know this is occurring? –Heat, redness, swelling, loss of range of motion, loss of function, and pain.

Cellular Response Early inflammation will have mostly neutrophils (Within first hour) –Will rid the site of bacteria and debris Second response will bring monocytes –Move slower and last longer Third response is microphages –Stimulates the repair process –Recycle amino acids to regenerate new collagen

Immune Response Cell and hormone mediated –Antibiotic response Tries to fight off any infection

Fibroblastic (Repair) Phase First phase of tissue healing –Osteoblasts: Regenerates bone –Fibroblasts: Regenerates tendons and ligaments –Cartilablast: Regenerates cartilage How do you know you are here? –Reduced pain and inflammation Fibroplasia –The process of connective tissue repair

Maturation (Remodeling) Phase Converts type3 collagen to type1 How do you know you are here? –Pain free, increased strength, increased range of motion, no signs of inflammation

Maturation (Remodeling) Phase Process of this phase –Stage 1 Days 2-4 Initial (Weak type3 collagen) –Stage 2 Days 5-21 Fibroplasia –Stage 3 Days Consolidation –Scar becomes more fibrous and less responsive to stress –Stage 4 Days Scar maturation

Factors that Impede the Healing Process Chronic Inflammation: Lasts longer than 30 days Extent of the Injury: The more sever the injury is the longer it will take Edema and Hemorrhage: Cuts off blood supply, impedes nutrition, inhibits neuromuscular control Poor Vascular Supply: Impedes nutrition

Factors that Impede the Healing Process Separation of tissue: Jagged edged injuries produce more scars Muscle Spasm: Causes traction on tissues Infection: Causes excessive scaring Hypertrophic Scaring: Rate of production is higher then rate of breakdown Atrophy: Strength