Week 11

Question 1

Phases of tissue repair and healing

Answer 1

Phase 1: Haematoma

Phase 2: Inflammatory Response

Phase 3: Proliferative Phase

Phase 4: Repair Phase

Phase 5: Remodelling Phase

Question 2

What are the two phases occurring in the repair phase?

Answer 2

Catabolic phase = breakdown of damaged tissue

Anabolic phase = formation of new blood vessels, production/
deposition of collagen and ECM (extracellular matrix) to bridge gap in the wound

Question 3

Anabolic phase involves

Answer 3

1. Angiogenesis
2. Fibroplasia
3. Matrix deposition
4. Re‐epithelialisation

Question 4

Catabolic phase involves

Answer 4

Breakdown of dead, dying
and damaged tissues by
micro‐ and macrophages

Question 5

Phase 5: remodelling phase involves

Answer 5

1. Collagen maturation (type III ‐> type 1)
2. Wound contraction (in secondary intention healing)

Question 6

Why is the remodelling phase important?

Answer 6

• Wound becomes stronger and more tolerant to load
• The key stimulus for this remodelling is mechanical stress – and this is where physios can play an important role!

Question 7

How does load influence remodelling?

Answer 7

Mechanotransduction = the process by which the body converts mechanical loading into cellular responses, and therefore structural change

Question 8

Not enough load during remodelling phase?

Answer 8

In the absence of mechanical stimulus, mechanotransduction signals are weak, and we see cell/tissue atrophy

Question 9

Too much load during remodelling phase?

Answer 9

Too much mechanical stimulus can ‘stress’ cells, which can alter their chemical expression (increased expression of catabolic chemicals) and lead to cell/tissue damage/breakdown

Question 10

PEACE & LOVE and when are they used to guide your approach?

Answer 10

Protection
Elevation
Avoid anti-inflammatories
Compression
Education
&
Load
Optimism
Vascularisation
Exercise

Immediately after injury - PEACE

After first days have passed soft tissues need - LOVE