The document discusses the different phases of wound healing: 1) Bleeding phase occurs immediately after injury and lasts 6-8 hours. 2) Inflammation phase begins within 6-8 hours and reaches peak reaction between 1-3 days to stop bleeding and begin clotting. 3) Proliferation phase lasts 2-3 weeks as collagen is produced to form scar tissue through granulation, contraction, and re-epithelialization. 4) Remodeling phase results in regaining strength over time but risk of breakdown remains high as structure and density are reorganized.

1. TISSUES RESPONSE TO
STRESS DIFFERENT STEPS OF
WOUND HEALING
Mr. Sachin S. Parsekar

2. MEANING
• Wound : injury to the body (as from violence, accident, or surgery) that
typically involves laceration or breaking of a membrane (such as the skin)
and usually damage to underlying tissues
• open wound
• closed wound

3. • Healing : Tissue healing is defined as The replacement of Destroyed tissue
• Healing is body response to injury in attempt to restore normal structure and
function

4. PHASES OF WOUND HEALING
• Bleeding phase
• Inflammation phase
• Proliferation phase
• Remodeling phase

5. BLEEDING PHASE
• This is a short phase immediately after injury, lasting about 6-8 hours, and
up to 24 hours after a crush injury. The time of the bleeding will depend on
the extent of the soft tissue injury and the management thereof. The more
vascular the injured structures, the more bleeding will occur

6. INFLAMMATION PHASE
• The goal of the inflammation phase is to stop the bleeding phase.
• This is achieved by retraction of injured blood vessels and clotting. The
blood supply to the area increases in this time. This phase starts rapidly
within a 6-8 hours after the soft tissue injury, reaches the maximal reaction
between 1-3 days.
• Blood vessels contraction initiated by platelets plug formation
• WBC destroy bacteria incase of open wound and prevent infection
• Plasma comes out as results in swelling
• Bleeding will lead to redness

7. PROLIFERATION PHASE
• During this phase, collagen is produced to form scar tissue. This phase starts between 24-48 hours
after injury but lasts up to 2-3 weeks when the bulk of the scar tissue is formed.
1. Granulation: fibroblast produced for reconstruction of capillaries, give strength,
and structure of tissue
2. Contraction: decreasing size of wound by margin contracts or edges pull together
3. EpithiliazatIon: (Sealing of wound ) Epithelial Layer provides a seal between
underlying wound and environment.

8. REMODELING PHASE
• It is also known as maturation phase
• The result of this phase is Regain densal strength, reorganize structure,
gain natural strength.
• However in this phase Risk of break down of tissue is high.

9. MANAGEMENT OF INJURY
1. Phase : PRICE should be given to reduce pain and swelling. Pain free range of
motion with cryotherapy
2. Phase: starts when inflammation singns are reduced. I.e. swelling, pain ,redness.
This phases is to prevent muscle atrophy. Pain free full range of motion with
concentric strengthening. If pain than reduce intensity
3. Phase (Remodeling phase): stretching to avoid lose of flexibility, Eccentric
Strengthening to make sure muscle is already regenerated Which will prevent
injury
4. Phase: Aim us to return to sports Without reinjury. Solution to avoid reinjury is to
Increase strength, flexibility, endurance, Speed
5. Phase : Main aim is to Return to competition without reinjury With strength,
coordination, psychological readiness For this Progressive Agility and stabilization
should be practice

10. CLINICAL BOTTOM LINE
• Tissue healing is natural process that occurs in body after injury
• It is very important To select Most appropriate Therapy at each stage

11. THANK YOU