Types of Wound Healing Flashcards
Healing by First Intention
AKA primary union
Clean surgical like injury allows edges of wound to approximate
Little to no scar
Healing by Secondary Intention
AKA Secondary Union
Tissue defect is large, may be dirty wound
Typical has a more significant inflammatory reaction
Increased granulation and myofibroblast activity
Produces scar
Realignment Theories - Induction Theory
Scar tries to mimic characteristics of healthy tissue
Tissue structure induces the collagen weave pattern
Clinical Implication - Induction Theory
Separte healing tisues
Positioning of body part, surgical repair consideration
Early controlled motions
Realignment Theories - Tension Theory
Internal/External Stressted contorl the development including stength
Forces with Tension Thoery
Muscle Tension
Temperature changes
Joint Movement
Soft tissue loading and unloading
Clinical Implications for Tension Theory
Phase of repair process when forces introduced
How forces applied
Low load duration stretch
Effects of immobilization
Clinical COnsiderations
Controlled Activity
Tissue develops its maximum strength in direction that the forces are applied
Excessive force will re-njure
Management Goals
Return to Function Increase Strength Increase joint ROM and soft tissue mobility Increase motor control Increase muscle endurance
Immobilization
Muscle has dec number of sarcomeres - dec strength - inc contractile time - dec speed of contraction Inc density of connective tissue at permysial and endomysial levels
More on immobilization
Dec GAGs - so inc number of cross links
Capsule and ligaments thicken
Ligaments are weakened
Effects of Exercise
Increased ligamentous strength
Decrease amount of sarcomere loss
Reduce collagen thickness
Modalities will…
effect healing process
Ultrasound, thermal agents, electrical stimulation
Chronic Inflammation States
Primary cell = macrophage
Stimulation fibroblasts without stimulating other components
Leads to inc amounts of dense CT
Clinical presentation for chronic inflammation
Pain
Swelling
Stiffness that progreses over time