Tissue Healing

• Why do contractures occur in wound healing relating to amputation?

  Problem with recontraction

  If full ROM is not initiated in early stages after amputation -> develops contractures

  Abnormal shortening of muscle tissue = muscle highly resistant to stretching

  Fibrosis of tissues supporting muscle or joint
• What are the factors that influence tissue repair?

  Infection

  Smoking

  Immunosuppression

  Age

  Chronic conditions

  Hypoxia

  Wound management
• What are the 4 stages of tissue healing?

  Haemostasis

  Inflammation

  Proliferation

  Remodelling
• What happens in haemostasis?

  Vasoconstriction

  Formation of platelet plug
• What in inflammation stage of tissue repair?

  Early stage

  • local vasodilation
  • recruitment of inflammatory cells

  Late stage

  • resolution of inflammation
  • macrophages M1 -> M2
  • production of anti-inflammatory cytokines & growth factors
• What happens in the proliferative stage of tissue healing?

  Angiogenesis

  Formation of granulation tissue

  Re-epithelialisation

  Wound contraction