Week 7 Soft Tissue Injury & Tissue Repair

Question 1

What are the 4 “I’s” that cause tissue damage?

Answer 1

• Injury
• Infection
• Infarction
• Immune reactions

Question 2

There are 2 types of body tissue that repair in very different ways. What are they & how do they heal?

Answer 2

1. Parenchymal tissue - heals through regeneration.
2. Stromal tissue - heals through connective tissue repair.

Question 3

What type of cells have the ability to regenerate?

Answer 3

• Liable cells - e.g skin
• Stable cells - e.g. liver
• Fixed cells - e.g. nerves

Question 4

There are 2 types of connective tissue repair. What are they & what is the difference between them.

Answer 4

1. Primary tissue repair
2. Secondary tissue repair

primary tissue repair occurs as a result of a surgical wound. They heal in the same way.

Question 5

What are the phases of primary & secondary intention healing?

Answer 5

1. Inflammatory Phase,
2. Proliferative Phase,
3. Remodelling Phase.

Question 6

What is the timing for the proliferation phase of soft tisue repair & what occurs?

Answer 6

• 24-48 hours post injury.
• Fibroblasts, macrophages & blood vessels proliferate to form granulation tissue. The capillary network is leaky allowing WBC & plasms proteins to leak into the tissues. Collogen synthesis continues & reaches a peak betweek 5-7days & lasts for several weeks.

Question 7

What is the time scale for the remodelling phase of soft tissue repair?

Answer 7

Begins at 3 weeks & can last for up to 2 years. At the end of 3 months the wound strength has reached 70% of normal.

Question 8

What types of physiotherapy treatment could be used during the remodelling phase of soft tissue repair?

Answer 8

• Gentle stretching to stress the area so that micro piesto electric currents allow the scar tissue to be laid down along the lines of stress which will make it stronger.
• Occassionally frictions are reqired to remove knots of collogen.

Question 9

Name 4 factors that affect healing?

Answer 9

Malnutrition, redused blood flow & oxygen delivery, infection, associated illness/immunity, wound separation, foreign bodies, age, nature of injury, site of injury, sinus & fistula formation, temperature, drugs (steroids & NSAID’s), vitamin deficiencey (A,C, & E), mechanical stress, previous radiation therapy, pressure