wound healing dr

2.  Repair begins early in Inflammation.
 Hallmark of healing is Proliferation of Fibroblasts &
vascular endothelial cells.
 Soft, granular, beefy red appearance on the surface of
the Wound.
 New granulation tissue is Edematous due to passage of
Fluids, proteins & RBCs.

6.  Proteolytic degradation of BM of parent vessel
 Migration of Endothelial cells towards stimulus
 Proliferation of Endothelial cells behind migrating cells
 Recruitment of Peri-endothelial cells

7. Growth Factors & Receptors
- VEGF, FGF & Angiopoietin
- PDGF
 ECM (Extra Cellular Matrix) Proteins
- Integrins
- Matricellular proteins
- Proteases

8.  ECM is secreted locally and assembled.
 It is important for water & mineral storage.
 Gives rigidity to the Tissues.
 Reservoir fro growth factors
 Helps in Cell-Cell, Cell-matrix interaction.
 Helps in cell Adhesion, Migration & Proliferation.
 Synthesis degradation process is seen in Healing, Tumor
growth & Metastasis

9.  Most wounds heal efficiently, the end product may not be
perfect
 Epidermal appendages do not regenerate.
 Superficial wounds the epithelium is reconstituted without
scar.
 Fetal Cutaneous wounds heal without scar formation.

10.  Divided into 4 phases:
 Inflammation
 Granulation tissue formation
 Epithelial cells proliferation
 Wound contraction, ECM deposition, Remodeling.
 Two types of Cutaneous wound healing:
1. Healing by First Intention
2. Healing by Second intention
CUTANEOUS WOUND HEALING

11.  At the end of 1st week the wound strength is 10%.
 At the end of 3rd month the strength is 70 to 80%.
 Excess collagen synthesis is there from 2nd month

12. SYSTEMIC FACTORS
 Nutritional status
 Metabolic status
 Circulatory status
 Hormones Eg. Glucocorticoids

13. LOCAL FACTORS
 Infection
 Mechanical Factors
 Foreign bodies
 Size , location , type of wound

14.  Deficient scar formation
- Wound dehiscence
- Ulceration
- Non healing
 Excessive formation of scar
- Exuberant granulation tissue (Proud flesh)
- Keloid
 Contractures

15.  Non-Union
 Mal-Union
 Delayed Union
 False Joint or Pseudoarthrosis
 Joint Ankylosis
 Involucrum Formation
 Infections:: Osteomyelitis.

17. G0 Phase
Continuously dividing
cells : Labile cells:
GIT, Skin
Quiescent / Stable cells :
Liver
Permanent cells :
CNS, CVS

18. Cultured
embryonic
stem cells
Different culture
conditions
Liver cells
Nerve cells
Heart muscle cells
Different types of
differentiated cells

19.  Regenerative medicine – permanent repair of failing organs
e.g.
 Cardiomyocytes for heart disease
 Islet cells for diabetes
 Neural cells for Parkinson’s
 Blood cells for cancer
 Chondrocytes for osteoporosis
 Keratinocytes for burns