Stages of soft tissue healing

Question 1

1. Bleeding

Answer 1

• first few hours

- converts prothrombrin into thrombrin and fibrinogen into sticky fibrin clot

Question 2

Acute inflamation causing pain

Answer 2

• triggers include chemical (acid inbalance) infective (bacteria etc.) immunological
• substance P, bradykinins, histamines and resotonin trigger released by mast cells
• this chemical soup irritates nociceptors (A delta and C fibres

Question 3

5 cardinal signs of inflammation

Answer 3

• heat
• pain
• swelling
• redness
• function loss

Question 4

3. Proliferation

Answer 4

• 24 hours after injury (peaks at 5 days)
• fibroblasts are attracted to the area
• fibrin is degraded and replaced with extracellular matrix
• Type 3 collagen is laid down

Question 5

4. Remodelling

Answer 5

• 2 weeks to a year

- immature type 3 collagen is re absorbed and replaced with type 1 collagen (greater tensile strength)

Question 6

POLICE during inflammatory phase

Answer 6

• protect
• optimally load
• Ice
• Compress
• Elevate

Question 7

Purpose of inflammation

Answer 7

• eliminating cause of tissue injury
• clearing out dead cells
• initiating tissue repair

Question 8

2. Acute inflammation

Answer 8

• Mast cells and macrophages release chemical mediators e. bradykinin histamine serotonin and tumour necrosis factor A
• these cause chemical and vascular changes around site of injury
• Substance P and serotonin cause the blood vessels to dilate - which causes heat and redness
• bradykinin and histamine cause increase in permeability which decreases osmotic pressure
• this helps dilute toxins and attract healing cells to the area
• neutrophils and macrophages engulf bacteria and debris

Question 9

Healing time frames

Answer 9

Bleeding: first few hours
Inflammation: first few hours to a few days
Proliferation: 2 days to months (5 day peak)
Remodelling: 2 weeks to a year