Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Faculty of Medicine
Brawijaya University
Definition :
Regeneration
Healing
Control of Normal Cell Proliferation and Tissue Growth
Cell cycle
Tissue Proliferative Activity
Growth Factor
Extracellular Matrix (ECM) and Cell-Matrix Interactions
Repair by Healing, Scar Formation, and Fibrosis
Healing :
Scar Formation
Cutaneous Wound Healing
Primary Union
Secondary Union
Wound Strength
Local and Systemic Factors That Influence Wound Healing
Regeneration
1. Definition :
Growth of cells and tissues to replace lost
structures
2. Occurs if the ECM framework is not damaged / intact
( framework provide for cell migration and maintain
the
correct cell polarity for re-assembly of multilayer
structures )
3. Regenerated cells :
- Original cells
- Stem cells
Note :
Stem cells :
- Embryonic stem cells
- Adult stem cells
* Hematopoietic stem cells / HSCs
* Tissue stem cells
- Asymmetric replication
Healing
1.Definition :
A tissue response
* to a wound (commonly in the skin),
* to inflammatory processes in internal
organs, or
* to cell necrosis in organs incapable of
regeneration
2. Occurs if the ECM framework is damaged
3. Healing consists regeneration and scar
formation
may restore original structures but
involves
collagen deposition and scar formation.
Figure 3-1 Tissue response to injury. Repair after injury can occur by regeneration,
which restores normal tissue, or by healing, which leads to scar formation and fibrosis.
TISSUE-PROLIFERATIVE ACTIVITY
Growth Factor
Epidermal Growth Factor (EGF) and
Transforming Growth Factor- (TGF-)
-EGF : * Mitogenic for a variety of epithelial cells,
hepatocytes, and fibroblasts.
* Produced by keratinocytes, macrophages, and
other inflammatory cells in wound healing
Scar formation
Growth factors and cytokines released at the site of
injury induce fibroblast proliferation and migration
into the granulation tissue framework of new blood
vessels and loose ECM that initially forms at the
repair site.
Three processes that participate in the formation of
a scar:
(1) emigration and proliferation of fibroblasts in the
site of injury,
(2) deposition of ECM, and
(3) tissue remodeling.
Figure 3-21 Steps in wound healing by first intention (left) and second intention
(right). Note large amounts of granulation tissue and wound contraction in healing by
second intention.
WOUND STRENGTH
At the end of the first week, wound strength 10%
increases rapidly over the next 4 weeks.
This rate of increase then slows at the third
month after the original incision reaches a
plateau at about 70% to 80% of the tensile strength
persist for life.
Systemic factors :
Nutrition : Protein deficiency, vit C deficiency
inhibit collagen synthesis
Metabolic status : Diabetes mellitus
(microangiopathy)
Circulatory status : arteriosclerosis / venous
abnormalities (e.g. varicose veins)
Inadequate blood supply
Hormones : glucocorticoids
inhibit collagen synthesis.
Local factors :
Infection : persistent tissue injury and inflammation.
Mechanical factors : early motion of wounds
delay healing, by compressing blood vessels
and separating the edges of the wound.
Foreign bodies : fragments of steel, glass, bone
Location : wounds in richly vascularized areas
e.g.faceheal faster than those in poorly
vascularized ones e.g. foot.
Size : small incisional injuries heal faster and < scar
formation than large excisional wounds
Type of wound : wounds caused by blunt trauma
heal slower
Thank You
For
Your Attention