Types of Wound Healing Flashcards Preview

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Flashcards in Types of Wound Healing Deck (25):
1

Healing by First Intention

AKA primary union
Clean surgical like injury allows edges of wound to approximate
Little to no scar

2

Healing by Secondary Intention

AKA Secondary Union
Tissue defect is large, may be dirty wound
Typical has a more significant inflammatory reaction
Increased granulation and myofibroblast activity
Produces scar

3

Realignment Theories - Induction Theory

Scar tries to mimic characteristics of healthy tissue
Tissue structure induces the collagen weave pattern

4

Clinical Implication - Induction Theory

Separte healing tisues
Positioning of body part, surgical repair consideration
Early controlled motions

5

Realignment Theories - Tension Theory

Internal/External Stressted contorl the development including stength

6

Forces with Tension Thoery

Muscle Tension
Temperature changes
Joint Movement
Soft tissue loading and unloading

7

Clinical Implications for Tension Theory

Phase of repair process when forces introduced
How forces applied
Low load duration stretch
Effects of immobilization

8

Clinical COnsiderations

Controlled Activity
Tissue develops its maximum strength in direction that the forces are applied
Excessive force will re-njure

9

Management Goals

Return to Function
Increase Strength
Increase joint ROM and soft tissue mobility
Increase motor control
Increase muscle endurance

10

Immobilization

Muscle has dec number of sarcomeres
- dec strength
- inc contractile time
- dec speed of contraction
Inc density of connective tissue at permysial and endomysial levels

11

More on immobilization

Dec GAGs - so inc number of cross links
Capsule and ligaments thicken
Ligaments are weakened

12

Effects of Exercise

Increased ligamentous strength
Decrease amount of sarcomere loss
Reduce collagen thickness

13

Modalities will...

effect healing process
Ultrasound, thermal agents, electrical stimulation

14

Chronic Inflammation States

Primary cell = macrophage
Stimulation fibroblasts without stimulating other components
Leads to inc amounts of dense CT

15

Clinical presentation for chronic inflammation

Pain
Swelling
Stiffness that progreses over time

16

Prcautions

no sign of inflammation
Discomfort as activity progresses but not lasting more than a couple of hours after

17

Signs that activity is progressing too quickly

Joint sweling
Pain longer than 4 hours and requires meds for relief
Dec in strength of flexibility
Fatigue more easily

18

Chronic Recurring Pain

Pain that occurs from old injury might be result of:
- Return to function too early
- Scar tissue tearing
- Stressed with repeated or vigorous activity

19

Tx approach with Chronic Recurring Pain

Treat as an acute injury
Develop program to correct faulty mechancs or faulty habits may be sustaining the problem

20

Stretchin

1. Alignment
2. Stabilization
3. Intensity
4. Duration
5. Speed
6. Frequency
7. Mode

21

Rules for Stretching

1. Position so that you are stretching the target tissue
2. Avoid forces and movements that produce a reflex muscular action
3. Inc only to functional limits
4. Do not produce an inflammatory reaction

22

Stretching - Patient Sensations

Tightness/Tension in tissue being targeted
Burning sensation in tissue being stretched at 20 sec mark
No distal burning should be felt
In tissues that are chronically inflamed, may have ache in joint

23

Clinical Observations - Stretching

Relaxation in first 20 sec
Patient holds breath = too much
Relaxation response by patient and tissue
Tissue should be taut but not painful

24

Response to Stretching Treatment

Body part will feel clumsy or unsteady for first few seconds after
Discomfot lasts for only few minutes after

25

Improper Technique - Stretching

If patient has sensations of discomfort in areas of distal or proximal
If patient describes pulling sensation during stretch - likely not positioned properly
Sharp, sore joint pain descriptors
If patient feels threatened