Wound healing

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  • 1. Occurring when a wound is closed within a fewhours of its creation. Wound edges are surgically or mechanicallyapproximated, and collagen metabolism provides long-term strength. Occurs when a poorly delineated woundis left open to protect against wound infection. The open wound allowsfor the natural host defense to debride the wound before closure. Occurs when an open full thickness wound isallowed to close by wound contraction and epithelialization. Thickness Wounds – Occurs when a partial-thickness wound is closed primarily by epithelialization. This woundhealing involves the superficial portion of the dermis. There is minimalcollagen deposition, and an absence of wound contraction.
  • 2. Whether wounds are closed by primary intention, subjectto delayed primary closure or left to heal by secondaryintention1, the wound healing process is a dynamic one whichcan be divided into three phases. It is critical to rememberthat wound healing is not linear and often wounds canprogress both forwards and back through the phasesdepending uponintrinsic and extrinsic forces at work withinthe patient
  • 3.  Two types of factor influence the wound healing :A. Local feature :1. infection.2. Poor blood supply.3. Movement.4. Foreign body.5. Exposure to ultraviolet ray.6. Types , size and local of injury.
  • 4.  Systemic feature: Age. Infection. Nutrition :arginine and vita A. Hypoxia. Anemia. Hypo perfusion. Metabolic disorder : D.M. And uremia . Steroid and radiation.
  • 5.  Infection. Epidermal cyst formation. Pigmentation. Deficient scar formation. Incision hernia. Hypertrophied scars and keloid formation. Extensive contraction. Neoplasia.
  • 6. Growth factor Abbreviation Main origin EffectsEpidermal growth factor EGF •Macrophages. Granulation •Salivary gland. tissue formation. •Keratinocytes.Transforming growth TGF-α •Hepatocyte andfactor-α epithelial cell proliferation. •Activated •Expression of macrophages antimicrobial •T-lymphocytes peptides. •Keratinocytes •Expression of chemotactic cytokines.Hepatocyte growth factor HGF Mesenchymal Epithelial cells and endothelial cell proliferation Hepatocyte motilityVascular endothelial growth VEGF Mesenchymal Vascularfactor cells permeability Endothelial cell proliferation
  • 7. Platelet derived growth PDGF Granulocyte,factor macrophage, fibroblast and smooth muscle •Platelets cell chemotaxis •Macrophages Granulocyte, •Endothelial macrophage and cells fibroblast •Smooth muscle activation cells Fibroblast, •Keratinocytes endothelial cell and smooth muscle cellFibroblast growth factor 1 FGF-1, -2 Macrophages Fibroblastand 2 Mast cells chemotaxis T-lymphocytes Fibroblast and Endothelial cells keratinocyte Fibroblasts proliferation Keratinocyte migration Angiogenesis