Logy Course 5

li.:irini: kg.nc.rlion &.ooncrn{ rnrlir Corr:'

5

Healing

'

Healing is the ability of lhe body

.

Healing of innammatory esons s based on 2 types ol prccesses:

- to repla@ dY ng cels - to repatrdamageo tssues

REGEN ERATION

. . .

Reoeneration means the mofphological an' iunitlonat restor:ng ot the damaged ilssue by the same tYPe of iissue li occurs in iniuled tissues that have kept capacitY oi cell division Afier cell division capaciiy, we disting!ish 3 disiinct celliYPes:

Labile cells

Stable cells

Pefmanent cells

rear;q;',nPdP

'e@€iieorhe

kGd *

ccNf.iECT|./: aEPAI: REPAIR BY CONNECTVE T SSUE

esemEted pa,eichyro) by

tpe

or I ssue (non_

aeiiedve

vasc! ar

duerovarous paihoosclpro€tsestMammaion necrcss erc ) whch produ€ pa€nchyma ateratore

The healing process

- rl

'i.:.=i rl

Healing by connective rePah

oj4eindMss:seib[oiu::

VascLrlar ranulation tissiJe

Fibrovascular

ranulation tissue

h€aing@m&areedemddgblhE65t4d

smooth mlscle (

nyofltoblsb').

Fibrcus gEnulation tissue; coiheclve scar

Reductlon of b ood vessels.

l"lorplro oqY

oigra.! ri o.l sjle

or con.ecnve vasc!lar tissue ofneolormalon

Vascular granulation tissue .

vascular granuraron . lissue is composeo or: la) numerols caP lanes of .eoformalion having thick basement membrane and swollen €ndotheLum , a lowing lh-. Passage ol leucocyie diaPedes sl {b) innammalory ceLLsr PIrN N,lf, Lv;

Fibro-vascular granulation tissue

.

f bo-vascuLa. q€nuLatior

niamrutory

ele (Ly P.

Fibrous g ranulation tissue

affanged jn fascicles.

Evolution lf evolutign is going well

-there is suffjcieni collagen to flllthe gap

'most of the capillaries are rcabsorbed -the fibroblasts reveri io a rcsting mode. -and finally ihe myoflbfoblasts contractthe ilbrous

tissuet

scar,

Factors that

inf

luience healing

Local factors (deLaY heaLing): - iissue ateration dle io supefadded infection

-.educed

b ood suPP Y

I hssue hdhem a affecls tssue €Pa r - rp pr.s-r.eoia'o,egn-raler d a k d' r r id's

-

fo

infectLo. by prornotr.q inf amma!on exposureio rad alion reduces{he ablityolhealing oi

denervation ofan area car de ay healng tissue chronic nflammaton ihal progresses ionstula Iorrnaton inh bits hea ng

Factors that influience healing Age. tlre adequac ab ry of inf smnatory.espoise decreases are n€c.ssafv fo,.o aqen s),nihesls and . "c "bnin :.1!atof,ol.ironc nfamm:i on or di5sem naLLon leq ib(i

-

MedLd

n€s

t.6soJ q u.oadi.o da,

healno (susceot

$$eirb' i. ty

ds due 10 her toLo'a mre' on

pred spose

b iv 1o cardEvascrLard sease and ncreaseo irecrionsl

Exampes.rrep;trproce:se:

2al on !s1he p.ocess ol acemed oftissue leslons ihrough a

Connectjve

ep

orlai

conneclive repair is th€ process ol €placemenl ol !€nulatDn tissue though Org.nlz

nO

tomaton

and repaira€ lead ng lo lhe tibrous scar.

of

Comedive orgdization of rhe intB-alveold fibrirous exudate (cafrincadon) ln lobar pneunonia, idd-alveoltr fibinous exudale is Fplaced bt gmulation lisue, resulting a tissle densincadon md llck of aeradon of

-

Crcssly, tlre apteddce of orgoized loba lung Na is resembling wilh a nds of mear Gmificarion) Comecriveorgeizationof lheintrapleural ibrinousexudale(svdphvsis) Rerlacins of inlrapleural ibrinous exudale wilh gonnlation tissue l@ds t0 rr,Jcreation orinmpteuacorn*live thickeniig Gtnphvsis) Comective orqmization of lhe intraDeftddial fibiiious exudale (adlBiois)

-

Repla;.goiinlrapericerdial fibinous exudate *ith grdulationlissue leads ro rLe cBalon of inlr.Feiicardial co.nectirc thickening (adhsronsl

organl2ation and repah of lesions Connat ve oruanization ol the

1,4,

examples otorg.nizatlon and rcp3k of

l6io's

Connecllve oaadlzation or the

-

Boo! Bircuaton

s donE

(a)ihdbus 6me zion gEnulat oi lissue leads

10

ihelmdonofaeandal

t0

ll. Encapsulation occu.sii

Large

reeons roo

large lhat can nd b€

va ous ocations) conneclive vascu

repars

s

to.m€d a

a

tissue or

lll. The wound healing The healing is performed by organizat'on repair and scaf fofmation; Types of wounds:

-

SLirgical wounds (HEALING BY PRLN4ARY INTENTLoN )l Opened wounds (of afge dimensions)i burns t|auMA (HEALING BY SECONDARY ]NTENT1ON )

]L

r a sugie rcund

!H$jti;"de,

haa.ng

(perpnrum ntenloo

",^""d,",*"d

b""d "

d

hte"

s!lgicalwound healifg (per primam intention)

surgcalwound h€ainq (per primad nieniioa)

r"ixiff#titrr'r."rx;

*." "-.,.,,." -. " ---.""".4"""'

' " li""i,f9----""-*, -'---"----''-'

tl

Surglcalwound healrrg

lllb. Healrng ollraunr wound {per second intention) These large surface

nnammalory response

wth.ole

n

elminati.g

L_1

Healing oltrauma rvo!no

Hea

ns.rtraunamlnd(p€r

rei€ s an €plhelun cov€rng

. '

after monilrs (fibrouslrssue conneclve scd matu.e I'brous

s made up or

lssle wrh

Paiaile to the surr:.e usund

ierence" oe:\,te-T wouncis uit'l primary and secondarY inlention

Di{

Dfe.ences n hELrs oflhe ? ML pztho og,c Prfte$ s esseda Y re;ame

lhe dudtoi

oi th€ repa r process d

i'e6

rilfi'-,""",."."".,,,,","","",r:o,o.es

the

adon of enz/mes rhJ

tr

nes oi torces (hethaoprot€ nases)

Complications

Trreromal.r orcollagen

n

5

.nqe.lhedisd