phases of healing

Question 1

phase 1

Answer 1

inflammation (0-5 days)-

• physiological- blood vessels dialate
  - fluid gets away from vascular system to increase edema

-clinical- 5 cardinal signs of inflammation- redness, edema, heat, pain, loss of function
(more edema=thicker bigger scar b/c more protien- not good/aggressive approach).

Question 2

phase 2

Answer 2

fibroplasia (4 days - 2-6 wks)
physiological- fibroblasts proliferate (most cell scar growth)
-new capillary growth (if you leave it alone it will contract/ wont stretch out/ granulation tissue/ MOBILIZE at this stage)
- wound looks red and granular
-random laydown of cells
-replacement of injured tissue w immature collagen that is devoid of architectural memory.
-increased strength along with collagen lay down for 3 wks

clinical- inflammation decreases slowly
-pain at end range of motion (not normal).

Question 3

phase 3

Answer 3

maturation (remodeling) 1 month - years
physiological - fibroblasts activity decreases (well healed)
-remodels according to tension applied- may shorten if left alone
-scar softens and becomes more pliable
-nutrition has effect
-newly formed scar shrinks in all dimensions and squeezes water out to extracellular spaces = collagen more dense – scar becomes more noticable

Clinical- thickened

       - increased pain, edema in beginning
       - muscle guarding (stiffness, tension)
       - stiff after rest
       - decrease ROM 24 hrs after doing too much (offending activity).