The Healing Process
By: John Delia
Inflammation Phase
• 3 Responses
– Vascular
– Cellular
– Immune
• Collective Function: Reduce microorganisms,
dead tissue, and any foreign materials
Vascular Response
• First Response (Initial 5-10 mins)
– Transient vasoconstriction with area’s vessels to
allow platelets into area to begin clotting
• Second Response
– Chemical events cause vasodilatation, to produce
an area of cell rich blood, allowing the area to be
flushed out
• How do we know this is occurring?
– Heat, redness, swelling, loss of range of motion,
loss of function, and pain.
Cellular Response
• Early inflammation will have mostly
neutrophils (Within first hour)
– Will rid the site of bacteria and debris
• Second response will bring monocytes
– Move slower and last longer
• Third response is microphages
– Stimulates the repair process
– Recycle amino acids to regenerate new
collagen
Immune Response
• Cell and hormone mediated
– Antibiotic response
• Tries to fight off any infection
Fibroblastic (Repair) Phase
• First phase of tissue healing
– Osteoblasts: Regenerates bone
– Fibroblasts: Regenerates tendons and
ligaments
– Cartilablast: Regenerates cartilage
• How do you know you are here?
– Reduced pain and inflammation
• Fibroplasia
– The process of connective tissue repair
Maturation (Remodeling) Phase
• Converts type3
collagen to type1
• How do you know
you are here?
– Pain free, increased
strength, increased
range of motion, no
signs of inflammation
Maturation (Remodeling) Phase
• Process of this phase
– Stage 1
• Days 2-4
• Initial (Weak type3 collagen)
– Stage 2
• Days 5-21
• Fibroplasia
– Stage 3
• Days 22-60
• Consolidation
– Scar becomes more fibrous and less responsive to stress
– Stage 4
• Days 60-360
• Scar maturation
Factors that Impede the
Healing Process
• Chronic Inflammation:
Lasts longer than 30 days
• Extent of the Injury: The
more sever the injury is the
longer it will take
• Edema and Hemorrhage:
Cuts off blood supply,
impedes nutrition, inhibits
neuromuscular control
• Poor Vascular Supply:
Impedes nutrition
Factors that Impede the
Healing Process
• Separation of tissue:
Jagged edged injuries
produce more scars
• Muscle Spasm: Causes
traction on tissues
• Infection: Causes
excessive scaring
• Hypertrophic Scaring:
Rate of production is
higher then rate of
breakdown
• Atrophy: Strength