Phases of Healing

Question 1

1. What is the 1st Phase of Healing

2. Define this Phase

Answer 1

1. Inflammation Stage (0-5 days).

2. The vascular and cellular responses that clears the wound of devitalized tissue, debris, and foreign materials.

Question 2

3 Physiological Characteristics of Phase 1

Answer 2

1. Fibroblast proliferate.
2. Blood vesicles dilate and cologne is produced.
3. Fluid escapes from the vascular system and causes edema.

Question 3

5 Clinical Symptoms of Phase 1

Answer 3

1. Redness.
2. Edema.
3. Heat.
4. Pain.
5. Loss of Function

Question 4

What is the 2nd Phase of Healing?

Answer 4

Fibroplasia (4 days to 2-6 weeks).

Question 5

5 Physiological Characteristics of Phase 2

Answer 5

1. Fibroblast proliferate (MOST scar growth occurs in this phase).
2. New capillary growth.
3. Wound looks red and granular (granulation tissue).
4. Random laydown of cells (cells have NO architectural memory).
5. Increased strength along with collagen laydown for 3 weeks.

Question 6

2 Clinical Symptoms of Phase 2

Answer 6

1. Inflammation slowly decreases.

2. Pain occurs at EROM (endROM).

Question 7

What is the 3rd Phase of Healing?

Answer 7

Maturation (Remolding) may last for years).

Question 8

5 Physiological Characteristics of Phase 3

Answer 8

1. Fibroblast activity decreases.
2. Remodels according to tension applied (may shorten if left alone).
3. Scar softens and become more pliable.
4. Nutrition has an effect.
5. Newly formed scar shrinks in all dimension and squeezes water out of extracellular spaces = more dense collagen.

Question 9

5 Clinical Symptoms of Phase 3

Answer 9

1. Increases pain.
2. Edema in the beginning of the phase.
3. Muscle guarding.
4. Stiff after rest.
5. Loss of ROM for 24hrs after doing to much of the “offending activity”

Question 10

What are 5 Therapist’s Role’s in the 1st Phase of Healing?

Answer 10

1. Address edema.
2. Calm inflammation.
3. Wound Care
4. Pain management.
5. Avoid aggressive handling which will lead to increased inflammation and promote further scaring.

Question 11

What is the Therapist’s Role in the 2nd Phase of Healing?

Answer 11

Facilitate gliding of the surfaces during the lay down of cells without increasing inflammation.

Question 12

What is the Therapist’s Role in the 3rd Phase of Healing?

Answer 12

Remolding of the scar by the means of: splinting, tension, AROM and stretching.

Question 13

1. In What Phase do the Fibroblasts Proliferate the most yet still have low scare strength?
2. Describe why

Answer 13

1. Phase 2- Fibroplasia
2. Because fibroblast are proliferating and the most scar growth occurs at this stage, but the scar is only at 15% of its strength as before.