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1、CHAPTER7WOUNDHEALINGMimiLeongandLindaG.PhillipsAllthreephasesmayoccursimultaneously,andthephasesmaytissueinjuryandresponseoverlapwiththeirindividualprocesses(Fig.7-1).wound-healingphasesabnormalwoundhealingInflammatoryPhasetherelationshipbetweenimmunityandwoundhealingDuringthei
2、mmediatereactionofthetissuetoinjury,hemosta-orregenerationsisandinflammationoccur.Thisphaserepresentsanattempttofetalwoundhealinglimitdamagebystoppingthebleeding,sealingthesurfaceofthewounddressingswound,andremovinganynecrotictissue,foreigndebris,orothertherapiesbacteriapresent
3、.Theinflammatoryphaseischaracterizedbynewhorizonsincreasedvascularpermeability,migrationofcellsintothewoundbychemotaxis,secretionofcytokinesandgrowthfactorsintothewound,andactivationofthemigratingcells(Fig.7-2).ThetreatmentandhealingofwoundsaresomeoftheoldestHemostasisandInflam
4、mationsubjectsdiscussedinthemedicalliterature.Yetdespiteknowl-Duringanacutetissueinjury,bloodvesseldamageresultsinedgeofthestepsinvolved,theexactmechanismsunderlyinginitialintenselocalvasoconstrictionofarteriolesandcapillarieswoundhealingarenotcompletelyunderstood.followedbyvas
5、odilationandincreasedvascularpermeability(Fig.7-3).ErythrocytesandplateletsadheretothedamagedTISSUEINJURYANDRESPONSEcapillaryendothelium,resultinginpluggingofcapillariesandWoundrepairistheeffortofinjuredtissuestorestoretheirleadingtocessationofhemorrhage.Activationoftheseplatel
6、etsnormalfunctionandstructuralintegrityafterinjury.DuringthebybindingtotheexposedtypeIVandVcollagenfromtheefforttorestorebarrierstofluidlossandinfection,reestablishdamagedendotheliumresultsinplateletaggregation.Theinitialnormalbloodandlymphaticflowpatterns,andrestorethecontactb
7、etweenplateletsandcollagenrequiresvonWillebrandmechanicalintegrityoftheinjuredsystem,flawlessrepairisfactor(vWF)VIII,aheterodimericproteinsynthesizedbymega-sacrificedbecauseoftheurgencytoreturntofunction.Regen-karyocytesandendothelialcells.Plateletadhesiontotheendo-eration,inco
8、ntrast,isperfectrestorationofthepreexistingtissuetheli
