Wound Healing

Question 1

What are the three phases of wound healing?

Answer 1

1. Inflammation phase
2. Fibroplasia phase
3. Maturation/remodelling phase

Question 2

Explain what occurs during the inflammation phase

Answer 2

Occurs from 0 - 4 days post injury.
Involves:
- Removing debris and dead/dying cells from the site of injury.
- Inflammation occurs
- Increased concentration of white blood cells

Question 3

Explain what occurs during the fibroplasia phase

Answer 3

Commences approx 4 days after injury and lasts for 2-6 weeks.
Involves:
- The initial formation of a matrix of fibrin, collagen and blood vessels
- Adhesions of structures occur
- Allow for controlled movement to avoid unwanted adhesions and muscle tightness

Question 4

Explain what occurs during the maturation/remodelling phase

Answer 4

Commences approx 3-6 weeks after injury and can last for months or years
Involves:
- Remodelling the sounds
- Re-organising the matrix formed in the fibroplasia phase

Question 5

What is the approx time frame for skin healing?

Answer 5

A few days to a week (if superficial).
Skin grafts/flaps can require a few weeks to heal.
Can tolerate movement in the first few days (2-5)

Question 6

What is the approx time frame for blood vessel healing?

Answer 6

Blood vessels that have been surgically repaired require 1 - 2 weeks in stretched/safe immobilisation

Question 7

What is the approx time frame for muscle healing?

Answer 7

3 - 4 weeks

Generally immobilised for 2-3 weeks before commencing gradual mobilisation

Question 8

What is the approx time frame for tendon healing?

Answer 8

6 - 8 weeks (12 weeks for full healing)

Blood supply is small and fragile

Question 9

What is the approx time frame for bone healing?

Answer 9

2 - 3 months (6 weeks immobilisation for adults, 2-4 weeks for children)

Question 10

What is the approx time frame for ligament healing?

Answer 10

3 - 4 months
Joints will be extremely unstable
Limited blood supply

Question 11

What occurs during the inflammation phase of bone healing?

Answer 11

0 - 5 days

• Oedema
• Bleeding into the marrow cavity
• Formation of fracture haematoma

Question 12

What occurs during the fibroplastic phase of bone healing?

Answer 12

6 days - 6 weeks
- Callus forms to bridge the gap between the two bone segments
Clinically, union is achieved when the fracture callus is strong enough to prevent movement at the fracture site

Question 13

What occurs during the remodelling phase of bone healing?

Answer 13

6 weeks onwards

- Gradual changes in shape of the nearly formed bone

Question 14

What treatment/interventions are relevant to wound healing (all phases)

Answer 14

• Oedema management
• Pain management
• Desensitisation
• Scar management
• Regaining full ROM
• Strengthening
• Immobilise tissues if required
• Protected movement if required
• Maintaining ROM of un-involved joints