The document discusses the mechanisms of healing and repair in tissues, outlining three processes: healing, repair, and regeneration. It details wound healing types, including primary and secondary intention, and describes the phases involved in each. Additionally, it highlights factors that delay healing and potential complications that may arise during the process.

1. Healing and Repair
Healing and Repair
General Pathology
Dr. Oromo Francis
Dr. Changkel Banak Riak

2. Healing and Repair
Healing and Repair
Healing:-
Healing:-
– Replacement of damage tissue
Replacement of damage tissue by
by living one.
living one.
Repair:-
Repair:-
– Replacement of damaged tissue by
Replacement of damaged tissue by fibrous
fibrous
connective tissue
connective tissue
Regeneration:-
Regeneration:-
– Replacement of
Replacement of whole
whole organ.
organ.

3. To heal
To heal OR
OR to repair
to repair
?
?
 Severity of factor.
Severity of factor.
 Type of tissue:-
Type of tissue:-
1.
1. Labile
Labile : Skin, GIT,...
: Skin, GIT,...
2.
2. Stable
Stable : Solid organs.
: Solid organs.
3.
3. Permanent
Permanent : CNS and muscles.
: CNS and muscles.

4. Mechanism of Healing
Mechanism of Healing
Interaction
with ECM
Soluble
mediators
Cell migration
Proliferation
Differentiation
Matrix formation
INYURY
Healing

5. Wound Healing
Two types:-
Two types:-
1.
1. By primary intention.
By primary intention.
 Clean surgical wound.
Clean surgical wound.
 Little damage.
Little damage.
2.
2. By secondary intention:-
By secondary intention:-
 Large contaminated
Large contaminated
 More damage
More damage.
.

6. Primary
intention
Secondary
intention

7. Primary Intention: Steps
Primary Intention: Steps
*
Clot formation
*
Inflammation
*
Demolition
*
Down growth
*
Granulation tissue
*
Scar
Scar
raised
Scar off Normal
(
resolution
)

8. Secondary Intention: steps
Secondary Intention: steps
Large clot
Inflammation
Granulation tissue
Epithelial migration
Blood vessels
fibers
Permanent scat
Wound contraction

9. Wound healing
Wound healing
Cells in healing
Cells in healing
 Epithelial cells.
Epithelial cells.
 Macrophages.
Macrophages.
 Endothelial
Endothelial
cells
cells
 Fibroblasts.
Fibroblasts.
Mediators
Mediators
:
:
 TGF-B.
TGF-B.
 FGF.
FGF.
 PDGF.
PDGF.
 CSF.
CSF.
 EGF
EGF

10. Wound healing
Wound healing
Primary /Secondary : Differences
Primary /Secondary : Differences
1.
1. Size .
Size .
2.
2. Cleanness.
Cleanness.
3.
3. Amount of granulation tissue.
Amount of granulation tissue.
4.
4. Scar .
Scar .
5.
5. Wound contraction.
Wound contraction.

11. Factors delaying healing
Factors delaying healing
Local factors
Local factors
– Ischemia.
Ischemia.
– Infection
Infection
– Foreign bodies
Foreign bodies
– Radiation , movement.
Radiation , movement.
Systemic
Systemic :
: factors -
factors -
– Malnutrition, deficiency.
Malnutrition, deficiency.
– immunity.
immunity.
– Old age
Old age

12. Complications of healing
Complications of healing
1.
1. Infections
Infections
2.
2. Wound adhesion.
Wound adhesion.
3.
3. Keloid formation.
Keloid formation.
4.
4. Incisional hernia
Incisional hernia
5.
5. Epidermoid cysts.
Epidermoid cysts.

13. Fracture Healing
Healing and repair

14. Normal Bone
Normal Bone
Cortex
Periosteum
Medulla
Medullary cavity
Anatomy
Histology

15. Clot Demolition
Inflammation
Granulation
tissue
Calus
formation
Gap
unio
n
Remodeling

16. •
Fracture Healing: Steps
Fracture Healing: Steps
1.
1. Heamatoma.
Heamatoma.
2.
2. Inflammation / demolition
Inflammation / demolition
3.
3. Granulation tissue.
Granulation tissue.
4.
4. Callus formation
Callus formation
5.
5. Union of fracture gap
Union of fracture gap
6.
6. Remodeling
Remodeling

17. Factors affecting #healing
Factors affecting #healing
 General
General
 Local.
Local.

18. Complications
Complications
Early:-
Early:-
– Bleeding
Bleeding
– Fat embolism
Fat embolism
– Avsculer necrosis
Avsculer necrosis
– Infections
Infections
Late
Late
– Delayed
Delayed union
union
– Mal union
Mal union
– An union
An union

19. Healing in other tissue
Healing in other tissue
 Muscles
Muscles
 Liver
Liver
 CNS
CNS
 kidney
kidney