Review Note
Last Update: 06/08/2024 12:29 AM
Current Deck: SLS Cards::9. Trauma
New Card (Unpublished)Currently Published Content
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Commit #106859
What is the normal physiology of wound healing?
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Commit #106859
- Hemostasis (key players platelets and clotting factors): outpour of lymphatic fluid and blood + activation of coagulation pathways --> aggregation of platelets (i.e. platelet plug formation) --> thrombosis (i.e. coagulation) --> fibrin mesh (scaffold for migration into wound of migratory immune cells) + arterial vasocontriction --> decreased bloodflow --> vasodilation to allow WBC and thrombocytes to region (i.e. vasospasm)
- Inflammatory (key players neutrophils and macrophages): WBC and thrombocytes increase inflammation by releasing mediators and cytokines; and praticipating in phagocytosis + platelet-derived growth factor and other factors promote collagen degradation, transformation of fibroblasts, angiogenesis, and re-epithelialization
- Proliferation (key players are fibroblasts, endothelial cells, keratinocytes): fibroblasts lay down new matrix consisting of fibrous collagen, elastin, and glycosaminoglycans (i.e. granulation) + reepithelialization with migration of cells + thicker and more durable layer of cells bridge thin superficial layer of epithelial cells + neovascularization through angiogenesis and vasculogenesis
- Remodelling (key players are fibroblasts and myofibroblasts): maturation strats around week 3 and can last for 12 months. Excess collagen/ matrix degrades (through cellular apoptosis), wound contraction (actin filaments in myofibroblasts) starts around week 3.