-
Steps of scar formation
- Resolution
- Restoration
- Regeneration
-
Resolution
Little tissue damage and normal restoration
-
Restoration
If resolution delayed, use old tissue for scar
-
Regeneration
Replacement of tissue by same tissue
-
Formations during fibroblastic phase
- Capillary buds
- Granulation tissue
-
Granulation tissue
- Consists of fibroblasts
- make collagen, elastin, ground substance, proteoglycans, glycosaminoglycans
-
Maturation and remodeling phase
- Long term (several years)
- Realignment of collagen relative to tensile force
- Continued break down and formation of collagen
-
Role of progressive mobilization
During remodeling phase, aggressive ROM ad strength for remodeling of collagen
-
Factors that impede healing
- Extent of injury
- Edema
- Hemorrhage
- Poor vascular supply
- Separation of tissue
- Muscle spasm
- Atrophy
- Corticosteroids
- Keloids and hypertrophic scars
- Infection
- Humidity, climate, O2 tension
- Health, age, nutrition
- Alcohol and tobacco use
|
|