Tissue Repair &
Electrotherapeutic Agents
Causes of Inflammation
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Soft tissue trauma
Fractures
Autoimmune diseases
Microbial agents
Chemical agents
Thermal agents
Irradiation
Foreign bodies
Inflammation & Repair
consists of 4 phases:
1.
2.
Initial injury phase (bleeding, clot,…)
Inflammatory response phase (prepares
wound for healing)
3. Fibroblastic repair phase, proliferation
(rebuilds damaged structures & strengthen
the wound)
4. Maturation phase, remodeling (modifies
the scar tissue into its nature form)
Initial Injury Phase
 Destruction of tissue (injury of cells)
 bleeding
Inflammatory Phase
 Signs of inflammation
Fibroblastic – Repair
(proliferative) Phase
 First few hours after injury  4 to 6
weeks
 Reconstruct (fibroblasts- endothelial
cells – macrophages)
 Resurfacing
 Strength of wound
Processes Occur in The
Proliferative Phase
 Epithelization
 Collagen production  fibroblasts
 Wound contracture 
myofibroblasts. Contract pulling the
ends of wound (scar)
 Neovascularization
Maturation (Remodeling)
Phase
 Takes months or years
 Change in size, form & strength of scar
tissue
 Fibroblasts, macrophages, myofibroblasts,
capillaries and water content of tissue
 The goal is restoration of prior function of
injured tissue
Factors Affecting Rate of
Maturation & Scar Characteristics
are:
 Fiber orientation
 Balance of collagen synthesis and lysis
Factors That Impede
Healing
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Extent of injury
Edema
Hemorrhage
Bad vascular supply
Separation of tissue
Muscle spasm
Atrophy
Factors That Impede
Healing
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Corticosteroids
Keloids & hypertrophic scar
Infection
Humidity climate & oxygen tension
Health, age & nutrition
Injury Management
 Cryotherapy
 RICE (rest, ice, compression &
elevation)
The Role of Progressive Controlled
Mobility in The Maturation Phase
 Wolff’s Law: states that both bone &
soft tissue will respond to the physical
demands placed on them, causing
them to remodel along the line of
tensile force.
Immobilization
 Control mobilization,
revascularization, muscle
regeneration & reorientation of
muscle fibers
 Active strengthening exercises in the
remodeling phase
 Modality not combined with antiinflammatory medication during
initial acute & inflammatory phases
Applied Electrical Charges
The effect on the body depend on:
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Intensity
Nature of resulting current
Chemical changes (direct current)
Stimulation of excitable tissues (
stimulating current)
 High currents  significant heating
(diathermy)
 Therapeutic modalities can restore
normal cell membrane potential and
leads to decreasing inflammation,
decreasing edema and increasing
healing.
 Good Luck 