TISSUE REPAIR

HOW WOUNDS HEAL

OVERVIEW
 Occurs in 2 ways:
 Regeneration – the replacement of destroyed tissue by the same kind of cells
 Fibrosis – involves repair by dense connective tissue, that is, by the formation of
scar tissue
 Which occurs depends on:
 The type of tissue damaged
 The severity of the injury
PROCESSES
Homeostasis
 Initial response of the body to a wound is to maintain homeostasis in the body
 To prevent blood loss and reduce the chance of infection spreading throughout
the body, circulation platelets within the blood begin to form a fibrin clot, which
seals the wound site
 Vasoconstriction (to isolate the wound site) and vasodilation (allows the required
cells to be recruited to the wound site) occurs in this process
 Vasoconstriction – constriction of blood vessels
 Vasodilation – widening of blood vessels
PROCESSES
Inflammation
 Injured tissue cells release inflammatory chemicals that allow the capillaries to be
very permeable
 This gives clotting proteins and other substances easier access to the injured area
from the bloodstream
 These proteins begin to construct a clot that:
 Stops blood loss by holding the edges of the wound together
 Block and prevent bacteria from spreading to surrounding tissues
PROCESSES
Formation of Granulation tissue
 Is a delicate pink tissue composed largely of new capillaries that grow into the
damaged area
 Is from undamaged blood vessels nearby
 Facilitates proper wound closure
 Contains:
 Phagocytes – will eventually dispose of the blood clot
 Connective tissue cells (fibroblasts) – produce the building blocks of collagen fibers to
permanently bridge the gap (scar tissue)
PROCESSES
Remodeling
 Regenerated surface epithelium makes its way between the granulation tissue and
the scab
 Scab detaches resulting in a fully regenerated surface epithelium that covers an
underlying area of fibrosis (scar)
 Scar appearance is dependent on the severity of the wound
ADDITIONAL INFORMATION
 Regenerative capacity of tissues differ
 Skin epidermis and mucous membranes (epithelial and connective tissues)
regenerate extremely well
 Skeletal muscle regenerates poorly while cardiac muscle and nervous tissues
within the brain and spinal cord are largely replaced by scar tissue
 Scar tissue may be strong but lacks in flexibility which may hamper functions if
it forms in organs such as the heart
 Contracture (permanent tightening) may occur as inelastic fibrous tissues replace normal
connective tissues