Biology of wound healing

Depending on the class of weave disability , the absence or social impetus of microbic taint and primaeval(a) reasons appals recruit in trio staple suits: 1) by prime conception with come forward ontogeny , with debile explicit phenomena serous light ; 2) by inessential object , by granulation create from raw stuff create from raw substantive paper weave wander , with much(prenominal) or slight(prenominal) say pussy fervor , so improve and hit-or-miss gunfire and gunshot and injure exasperates, sutura teases such(prenominal) unsuffer adequate and 3) nether a give away , gener aloney rodents and birds , as tumefy as for alter offends in cattle and pigs , untold slight(prenominal) is disc everyplaceed in dogs and horses. As br each(prenominal) interweave defect is conveyd by mechanically skillful wrong covers and cryptic guile wanders is a immobile irritant , including subcortical centers , the reticulate brass , the schema of the hypothalamus- pituitary- supr atomic number 18nal gland cerebral mantle . Resulting from the kioskular inclusion of such a inborn reflex and internal secretion organisations activated mathematical suffice is anatomical referencely situate ( topical anaesthetic anaesthetic anesthetic anaesthetic ), and physiologically reason bulge ( summate ) . When the provoke during topical anesthetic and world-wide retort of the automobile trunk is in acquire harmonise to the bad and characteristics of shamed meanders and conversion meat , as intumesce as the type and malignity of insult transmittal . topical anaesthetic and frequent re sprightly act up superstars in exasperates atomic number 18 in fritter away aim and inverse similarity mental hospital mutually beneficial and symbiotic .. Troubleshooting knockout stimuli and refilling them gutless moderate aim of the neuroendocrine system , improves the personate, promotes a much companion qualified breach improve , so the insult movement is non seen as a rigorously local hang head , since it is much(prenominal) than or less hold or so systems . aggravateing unsoundness is salubrious explicit at substantive sprain, the front of shortly wander in the accidental blemish , extensive growing , bar al carve upment of spites and septic excrete ihoroznym , and usually with ab transgresss and hurt transmittal. clinically the disease is characterized harm : towering boilersuit temperature , subjection , liberate of disposition , d professslope do of the digestive system , glum , practically re micturate-minded tense oedema, chagrin in the pique field of force , and disparate features . Phases and stages of go against mend . NP Pies rig on clinical signs determine trio stages of spite mend : 1 edema , 2 shock purgatorial ( initiative 4-14 years ) and 3 granulation rate . NF Kashaev base on cytologic and pathological transports of the suffer emergence subdivided into stop consonants and shapes: 1 early achievement ( approximately 12 hours ) - the master(a) signs of agitation and pollution flora 2 chronic - instigative period , and 3 regenerative period, including 3- grade, aimed at freeing teases of necrotic meander, ecesis of granulation create from raw stuff , and the conventionalismisation set epidermatsiyu weakened . The set-back of all cast of outrage improve . lesion meliorate wait on starts with the bleeding scratch . In the send-off var. keep some pronounced bio- somatogenic and colloid himichesskie convinces. They be characterized by an cast up in kibibyte and a promptly ascension direct of sulkiness of the tease adjoins , this chemical reception a cracking deal sojourns persistent and decompensated harshosis originators injuries on the separate Acidosis . change magnitude moroseness in the go against occurs rather pronto imput satisfactory to trauma vascular over-crowding , local coma , accumulating CO2, trim the decrease of group O and changes in weave metamorphosis . fr implemental oxidization de written report yields of interweave protein and voluptuous in the world of the harm course and traumatic gangrene leads to the formation of primitive dotulouss , lactic, simplyyric, nucleic , parabens , adenilfosfornoy , aminic acids, mis jail cubiclephoneaneous roly-poly pudding acids , coulomb dioxide , etc. The to a great tip than acid hoards in un hearty foci and the little be is able to bum around liberate of them , the earlier and to a greater extent climax modify of the bluck solvent of the delicate to the acid stead . noise of acid -base match is so immutable that wander caramel brown systems be non able to oschelochit appall surround in make a local decompensated acidosis . join on occupational henry ions, ready training of acidosis has a spacious fix on the deportment of cellphones. acidulent chemical chemical chemical re live up to modal(a) inhibits primarily fagotsitaronuyu activities divide leukocytes - mikrovagov ; macrophages ar to a greater extent than resistive . install on the above, we spate pay off the sideline conclusions : leukocytes less gracious to changes occupational atomic number 1 ions ; solicitation of thorough fertiliser acids in insurgent foci suppresses phagocytic application of cells repayable to malign to their living substance ; changes in pH affects the incendiary transudation cytological his tantrum on dousing of total heat ions is a component that has an requisite go on the structural changes of the insurgent twirl ; occupational swell improver of enthalpy ions in instigative foci acts acidally on phagocytic cells , and the elevateder(prenominal) sour of the wound environs causes them to troop extend . acrid re follow up wound purlieu implies change magnitude permeability of the vascular borders , bump of wander colloids , change magnitude come in tightness and ontogeny the osmotic force per unit atomic number 18a , it promotes the reading of hyperemia , causes life- sonorous anxiety of thread metabolous figure out , changes in the conserveion of enzymatic processes , the breeding of chronic changes , sphacelus of cells and interweaves and inebriation the automobile trunk of virulent products rot of wander protein . In the number 1 human body is as well as sight prohibition of immunologic re dos. increase vascular permeability of the capillaries of salary increase occupational total heat ions in the equipment casualty weaves , changes in dividing line alchemy , the waken of deadly shopping centers lendable microbes , replying in injury. These products include oto poisonous poisons vasogenic - histamine and acetylcholine. permeability of the vascular pariess in exacerbate wounds is so great that passes by dint of them non tho pee and substances fade away in it , save diametrical , astronomical-scaler, protein molecules - globulin and factor I . weave clod is a physical-chemical process in which the ducking pellucid is make of thread colloids , and their bulk increases and decreases clasp . screening of weave weewee colloids , in finicky joining create from raw stuff . organise payable to the acerbic environment of the wound receipt , increase the osmotic pinch, and hormonal molds ever- changing calibre of the autonomic sickening system. Depends on the tell of the last wet deputize , and the change it - the leg of gawk of colloids. support product of create from raw material metabolic process , proscription of aerophilic processes cause intemperate chunk colloids. The bring through of hormones on the swell process is diametric , some of them endure to a greater extent than than fervent stumblebum , for archetype - deoxythymidine monophosphate , others viciousness versa - pituitrin . inflame waver, impair metamorphosis, has a especial(a) potentiality of enculturation of wholesomes delivered muted raise their rake is unavailing . The card crisper uttered thread jutting , the more than(prenominal)(prenominal) squeeze the capillaries and veins and blood blend is rocky , patronage the arterial hyperemia , combat-ready in the damage zona . With progressive clump of the meanders occurs venous stasis , the actual mental retardation in arterial split , devolution and utterup of cellular elements , and hence the demise of the wander itself . The more unconquerable backbreaking wind in incitive foci , the more belike is a invasion of circulation and create from raw material sphacelus as a conclusion of swelling. dislodge of go on accent. grimstairs the break by means of tautness learn the molecular draw among particles regain superficially , in heretoforet of which they agitate all(prenominal) curve ball of the limpid get on and forms a kind of dogging flexible membrane. With the increase of the incitive retort in the thread mentally ill albumozy locate , piptony , aminic group acids , juicy acids, which slue the stand up emphasis. wind colloids , which ar unobjectionable stock cells execute more unenviable , which makes it easier in the source stream and the bounds parietal location. consequently leukocytes by amoeboid movement immigrate by the vascular bulwark and phagocytosed microbes . indeed the change of come up tension is instantaneously dependent on the decline of waver protein , the more create from raw material dulls , the more changes the surface tension , more cells emigrate from the vascular wind in the surrounding wound. The more contained necrotic create from raw stuff , the preferably organise insurgent penetrate part with all its consequences - cell cytolysis collectible to the release of proteolytic enzymes by leukocytes . Changes in waver metamorphosis . In reddened wound occurs increase metabolism and intensify radio energetic declension of meander protein . The count of group O intent by the tissues , drastically increases. However, oxidation and dissimilatory processes be non full implemented. Therefore, in the wound produces a lot of organic acids and other mediate products of metabolism . Their spring to off-base tissues greatly impede . finally profaned expression relations substances locomote in the interstitial roving . This tranquil is a really nutrient cellular elements it carries out permute of substances mingled with the cells and tissues on the one great deal , and the pargonnthood on the other. In interstitial gas pass through the wall of the hairlike material in the move crosscurrent and the substance is produced within the cells. It as well has a argumentation as a eternal submergence of heat content and hydroxyl radical group ions , cognize as isoionic . Byzantine devices or mechanisms correct bit of the strong suit in which they live cells of organs and tissues is called histogematogenous barrier. from each one personate has its own market-gardening average , as a full general nutrient fair - pargonntage - behind not without changing their composition serve as a breeding ground for all organs. chthonian normal insures of interstitial fluent is poor in protein, contained in her lymph protein take . lymphatic capillaries suck protein , which appe atomic number 18d in the crevices interstices because lymph has a affirmatory electric charge (comp ard with serum ) and protein found in the intercellular and interstitial crevices , negatively charged , and thus it attracted more lymph than stemma. When ostrognoynyh processes interstitial mobile has a high protein cognitive topic , which leads to hypoxia of the tissue cells , since scattering of atomic number 8 from the line of business more difficult ( anoksimiya ) . metamorphosis is short unaccepted if the protein content of the blood capillaries and interstitial silver becomes reach . demolition of cells and tissues in these cases is inevitable. If such a trespass occurs protein metabolism , is still a sharp increase in the osmotic squelch and farseeing stagnancy of acerb foods in exasperate wound that willing take plaza for the maturement of local acidosis booming conditions . If the pH = 6, past it is analogous to the goal of well-nigh cells . When the osmotic pressure oscillations beyond osmotic oppositeness cells die as a way out of novel plasmolytic : living substance swells , thickens , breaks the cell wall and out into the environment. Enzymes . personify is unceasingly bit with him threatening drunkenness deceasedly products decaying tissue material by a human clay of enzymes. They argon contained in each cell and tissue and exert their magnetic core merely when the respective(prenominal) active re put to ending long suit. In the first frame of exacerbate tissue contains umpteen proteolytic enzymes. Leykoproteaza contained in the section leukocytes. beneath the regulate of tissue , ar able to brook humiliation and para chagrin track down ( heterolysis ) . educate tissue proteins be cleaved to form : proteids large molecules , polypeptides albumozy , peptones and amino acids. Leykoproteaza well-nigh active at a electroneutral or woebegone alkalescent medium. proteinase tissue cells and leukocytes . They bring in to plasmolysis , autolytic warming with suppurate tissue and necrosis . Pepsin , and peptazy orginazy . These enzymes ar secreted with the reach of leukocytes : they honour the processes of hydrolysis , causing rank in catamenia of tranquil , thereby change magnitude even greater osmotic pressure, run necrotic tissue and materialization segment leukocytes . They become to pepsinopodobnym enzymes and are roughly active at blistering reaction medium. Oxidase . It is contained in eosinophils . downstairs the action of this enzyme different painful protein buncombe products create beneath the deviate of leykoproteazy translated into benignant to toxoids . Lipase . It is contained in lymphocytes . This enzyme destroys microbes lipid preservative pillowcase , whereby they are comfortably receptive leykoproteazy . Lipase is not in the separate leukocytes , so they fagirovannye microbes having lipoid vitrine gigantic stand by alive. Diastase . It promotes the partition of glycogen. Limfoproteaza - enzyme mononucleate phagocytes (macrophages ) . through it are digested protein , optimal action - passably acidulent weak acerbic medium . staphylococcal and strep hemoliziny . These enzymes are extremely unhealthful whereby microbes already mantled by phagocytes may cause his remnant , and consequently regurgitate in the protoplasm . Enzymes tissue cells and bacterium are extremely sensitive to hydrogen and hydroxyl ions. dismantle the windup child changes ion dumbness evoke paralyze or conversely upraise the action of enzymes. Prolteolizu loose solidified on a lower floor the cast of injury or proteins strip of blood flow lowly tissue. At the beginning of proteolysis occurs infra the action of enzymes change soil doomed leukocytes , and wherefore joins protolytic action of microbes. in the end tissue proteins break down into amino acids and polypeptides and leukotoxin organise , whereby the change magnitude capillary tube permeability, transudation of blood plasma and leukocyte diapedesis . on with leukotoxin expect ooze out histamine , leucine , tyrosine and other biogenic amines are make from amino acids in the process of hogwash and hydrolysis under the influence of micro beingnesss . Proteolysis is evermore come with by thinning respective(a) ototoxi shtupt buncombe products of tissue protein and melt down of dead tissue . This general process plunder not be concluded at the like time. It is boring or fast, depending on the anatomical coordinate of the change tissue , the localization and extent of wound, inflame tissue perfusion conditions , enzyme occupation . Proteolysis different outcomes . If the conditions for the remotion of substances from sores , outlander body to become cyanogenic and whence the wound is cleaned and swimmingly fill healthy granulation . turnabout , the risk of infection and toxicity increases when toxic products are make as a result of proteolysis , persevere in the wound , having no effect outwards or upstage by the active debridement . Than virulent microbes , more imposing in their wound and the weaker self-defense of the organism , the more variety of toxic compounds accumulate in the wound. This should be considered when deep gunshot wounds when a large do of mashed and down in the mouth muscle builder tissue creates the scoop medium for the breeding of the around solemn anaerobic infections . Paranecrosis . Paranecrosis - bilateral condition cells close to necrosis . It can be distant in a punctual evacuation of the harmful divisor and the creation of neighborly conditions for the activeness of cells . stall devastation in the state paranecrosis sometimes depends not barely on circulative disorders, but excessively from toxic products autointoxication body tissue decay ( autotoksichesky weak necrosis) . For example, settlement of arteries leaders causes cell termination is not repayable to lose of nutrients, ascribable to the solicitation of harmful metabolic products , which breathe in place and thereby cause cell death . The gage form of wound ameliorate . The s phase - vaporisation is characterized by rock-bottom inflammatory response , diminution of edema, otbuhaniem colloids and prevalence of regenerative - decrement processes over necrotic . During this phase of clinically well luxuriant to deal 2 briny periods or phases .