Beruflich Dokumente
Kultur Dokumente
REGENERATION
(Complete restoration of
OSCAR V.A. TAGULINAO, M.D., FPCS, FPAPRAS
Section of Plastic & Reconstructive Surgery
Department of Surgery
University of Santo Tomas physical integrity)
1
WOUND HEALING WOUND HEALING
3. COLLAGEN FORMATION
Appear starting 5th day
Tensile strength parallels collagen WOUND CONTRACTION
deposition
Centripetal advance of wound
4. SCAR MATURATION edge
Collagen fibers realign Resulting scar smaller than
Collagen cross-linkages original wound
(chemical bonding)
Myofibroblasts
Remodelling - collagenase
removes excess collagen
WOUND
CONTRACTURE
Excessive scar
Functional disability
WOUND HEALING
Wound strength
increases rapidly within 6
weeks & then plateaus. ABNORMAL
Tensile strength of scar WOUND
is only 30% of HEALING
unwounded skin
2
ABNORMAL WOUND HEALING
Keloid at sternal area
from scratching
EXCESSIVE COLLAGEN
FORMATION
Hypertrophic scars
asymptomatic thick scar
Keloidal scars
symptomatic scars beyond
the original borders
CHRONIC NON-HEALING
WOUNDS POOR PERFUSION &
OXYGENATION
Arterial insufficiency
Tobacco use
Diabetes
AGEING MALNUTRITION
Wound ruptures Hypoproteinemia
Ischemia Vitamin C deficiency
Delayed healing
3
ABNORMAL WOUND HEALING
INFECTED WOUND
Adequate debridement
Antibiotics
Delay closure