Tissue Repair

Question 1

Is regeneration possible if tissue injury is severe (with both parenchymal cell and stromal framework damage)

Answer 1

Regeneration is not possible

The main healing process here is repair by collagen deposition and other ECM componenets

Question 2

Does the fibroproliferative response restitute full function to the tissue?

Answer 2

Unfortunately, no

Question 3

What process are included in ‘repair’ by connective tissue deposition

Answer 3

• inflammation
• angiogenesis (VEGF)
• migration and proliferation of fibroblasts
• scar formation
• connective tissue remodelling

Question 4

Describe the role of inflammation in Tissue Repair

Answer 4

It contains the damage
Removes injured tissue
Promotes deposition of ECM
Stimulates angiogenesis

Question 5

What happens if the tissue damage persists and the inflammation becomes chronic?

Answer 5

Excess deposition of connective tissue, leading to fibrosis

Question 6

In most healing processes, a combination of repair and regeneraton occurs. What determines in which proportion one or the other occurs?

Answer 6

• Proliferative capacity of the cells of the tissue
• Integrity of the ECM
• Resolution or chronicity of the injury and inflammation

Question 7

List the pathogenic processes that can occur after repair

Answer 7

• Inadequate formation of granulation tissue
• Assembly of a scar (leading to wound dihiscence and ulceration)
• Hypertrophic scars and keloids
• Exuberant granulation

Question 8

Hypertrophic scars, keloids and exuberant granulation are the result of….?

Answer 8

Excessive formation of the components of the repair process

Question 9

What do we expect to see when exuberant granulation takes place?

Answer 9

Excessive granulation tissue which protrudes above the level of the surrounding skin and blocks re-epithelialization

Question 10

What can wound contraction lead to?

Answer 10

Deformaties of the wound and surrounding tissue