Regeneration Process of Tissues
When an injury is sustained, the body sets into motion various processes, which are needed to repair the damaged tissue. A Physical Therapist or Athletic Trainer can aid the natural repair processes of tissue by using various therapeutic modalities within an appropriate time shortly after an injury. This paper will discuss the physiological effects of therapeutic modalities and their relation to the regeneration process of tissues.
A. The injury process
The body's reaction to injury may be divided into two distinct parts. The primary response to injury is the tissue destruction directly associated with the traumatic force. Secondary damage occurs from cell death caused by a blockage of the oxygen
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Hence, the application of a modality at an improper point in its recovery phase may hinder, if not actually set back, the healing process (Starkey, 30).
Therapeutic modalities are used to control and limit the negative effects of inflammation by providing the optimum environment for healing to occur. Each modality used in the treatment of an injury should be judged for the effect it will have on the injury response process in the current stage of healing (Starkey, 31). The course of healing is described in three phases: (1) the acute inflammatory response, (2) the proliferation phase, and (3) the remodeling (maturation) phase
(Starkey, 12).
The acute inflammatory response involves the delivery of phagocytes, specifically fibroblasts, to the area and the formation of granulation tissue in an attempt to isolate and localize the trauma. During this time, histamine released from the traumatized cells increases capillary permeability, resulting in swelling as the proteins follow water out into the tissues (Starkey, 13).
During the proliferation phase, in which soft tissue repair occurs, the number and size of fibroblasts increase, causing ground substance and collagen to collect in the traumatized area in preparation to rebuild the damaged tissues. The injury process is completed during the maturation phase, when collagen and fibroblasts align themselves and attempt to adapt to the original tissue orientation and
Protein is obviously what everyone’s body part is made up of protein and so the fibrous tissue which is result to healing if low protein this tissue is not synthesized and high protein can increase it rates. Carbohydrates, as they are provide the main structural materials required for growth, repair, and maintenance of tissue. A&P 9th ed. Pg.50
This is the stage of the injury and will become the start of the rehabilitation process. When an injury occurs your body reacts immediately to heal it. This is often referred as the primary response mechanism. The main symptoms of primary damaged response are pain, bleeding and also inflammation.
Skin repair is an important physiological process which is essential for homeostasis, restoring barrier function and preventing infection (Martin, 2009; Boateng and Catanzano, 2015). Wound healing is defined as a complex, dynamic and the specific biological process associated with the phenomena of tissue regeneration and growth (Mazumder et al., 2016). Regeneration can be defined as a tissue that significantly damaged either completely or partially removed and tissue's original function and cell types must be functional and structurally restored (Mazumder et al., 2016). The process of healing comprises a cytokine, blood cells, extracellular matrix and growth factor (Joao De Masi et al., 2016). The growth factor is a protein that activates and
Epimorphic regeneration occurs when a limb is regenerated that contains the blastema at the wounded site. Theblastema will eventually regenerate the lost tissue. Epimorphic regeneration can also be reffered to add on regenration, where old cells provide the origin for the regeneration of the tissue that was lost. In the other type of regeneration a blastama is not formed at the wound site. This causes regeneration to occur with drastic rearrangement of any remaining tissue. The regeneration is classified based on whether the blastema is formed near the wound site or not.
For example, cellular swelling occurs due to cellular hypoxia, which damages the sodium-potassium membrane pump; as well as fatty change it can impair cellular function and damage the cell ability of adequately metabolize fat. Both situations are reversible when the causes are eliminated. In contrast, irreversible cell injury is the cell death with continuing damage, the injury becomes irreversible, which the cell cannot recover and dies. There are two types of cell death necrosis and apoptosis. When damage to membranes is severe, enzymes leak out of lysosomes, enter the cytoplasm, and digest the cell, resulting in necrosis ( McCance & Huether, 2014). Necrosis is the major pathway of cell death in many commonly encountered injuries, for example resulting from ischemia, exposure to toxins, various infections, and
Proliferative phase occurs within a few days of injury in which cells that were involved in the battle need to tend to their wounds and the regenerate to restore itself to its formal glory as best as possible. The body’s way of restoring itself is through use of angiogenesis, granulation tissue formation, wound contraction and epithelialization. This combination acts of getting new blood vessels to the damage area, aid in the formation of cells to fill in the area which leads to scar tissue, allow the skin to flexible in the repair process and finally resurface the wound with new epithelial
Spinal cord injuries are characterized by two distinct injury phases. The primary injury phase is represented by all the tissue directly damaged at the time of injury. The damage seen in this phase is primarily shearing of cells, destruction of local vasculature, and severe disruption of spinal cord function. The secondary injury phase is characterized by inflammation of the injury site, immune-mediated tissue destruction, and edema formation at the lesion site. The nature of spinal cord injuries makes the damage done by the primary injury irreversible. The majority of therapeutic research is done with the intention of lessening the damage done during the secondary injury phase. One major complication faced by researchers trying to control the secondary injury phase is the localized destruction of vasculature. Without a constant supply of oxygen and nutrients, many of the cells in the spinal cord will begin to die rapidly, oftentimes releasing biological signals that encourage other cells to die as well. The uncontrolled movement of fluid into the lesion site causes the tissue to swell, further complicating the processes of rebuilding vasculature. The movement of immune
For example, the signs and symptoms of wound infection could be confused with the inflammatory phase, while parts of the wound may be in the destructive phase, with other parts in the proliferative phase. Nevertheless, to recognise that the complex physiological process can be divided into distinct phases from the initial emergency response to injury through a process of repair and regeneration to complete healing helps the nurse in the clinical decision-making process.
To test for wound healing, excision wounds were created on THE exposed mice. The wound tissues were collected at various time intervals for 14 days after the injury. Looking at RNA concentration and using a spectrophotometer, the changes of expression level between exposed and non-exposed wound tissue were compared.
Step3, Phagocytes engulf dead cells and cellular debris. Step4, Platelets move out of the capillaries to seal the wounded area. The implantation of a biomaterial initiates the inflammatory response in a sequence of events following the implantation from acute inflammation to chronic inflammation to granulation tissue. Acute inflammation lasts a few hours to days. Histamine release and blood vessels near the implantation site become dilated and leaky. Neutrophils and plasma protein “escape” into tissue. Neutrophils are also called poymorphonuclear leucocyte (PMN). Area around the injury becomes swollen and red due to the increase of blood flow. Major role of neutrophils is to phagocytose (engulf and eat dead cells) microorganisms and foreign mateirals. Neutrophils are short lived. Predominate during the first few days of inflammation. Chronic inflammation is the 2nd stage of healing process. Presence of monocytes and lymphocytes. Monocytes differentiate into macrophages to phagocytose particles and break it down into smaller fragments. If the device is large, frustrated phagocytosis will occur where macrophages become larger by fusion and foreign body giant cells will
TGF-beta: promotes wound healing at the end of a response; comes from most immune cells or
Fibroblasts are mesenchymal cells that play an important role in the wound healing process. These cells are responsible for releasing inflammatory agents that recruit white blood cells to areas of damaged tissue. Fibroblasts also respond to these chemicals and differentiate into myofibroblasts. These myofibroblasts are characterized by their up-regulated rate of extracellular matrix component production and their ability to physically manipulate the extracellular matrix. When the wound healing process becomes unregulated, this results in what is referred to as a fibrotic response (Kendall). As a result fibrosis, or the thickening and scarring of connective tissues, occurs. Fibrosis is the excess deposition of ECM components like collagen and
The body will respond to an exercise stress in one of the three ways and there may be primary and secondary damage to the tissues as a result of exercise stress. The three responses the body will take to an exercise stress are, the tissues may adopt to the stress and no damage occurs, the tissues may become injured, or the tissues will die. In athletics, athletes often stress their bodies to the point of tissue injury and tissue death. The body’s primary reaction to an injury is tissue destruction. The degree of tissue destruction will greatly depend to an injurious force. Secondary damage may occur from cell death. Cell death occurs because of the hypoxia associated with the injuries area. The damage done in the primary stage is irreversible, but with a good rehabilitation program the secondary damage can be contained and limited. When the body is injured a sequence of events is initiated that leads to the eventual repair of the injury site. The first stage inflammatory response that immediately occurs following tissue damage. Its main functions are to defend the body against harmful substances, dispose of dead or dying tissue and promote the renewal of normal tissue. The inflammatory reaction is normally characterized by five different signs:
Capillaries then grow into the fracture hematoma, while phagocytes start to clean up the dead cells within the injury site. The fracture hematoma becomes more organized into a procallus. Fibroblasts from
(Godwin & Rosenthal, 2014). Additionally, research has demonstrated that during wound healing, changes occur in the thymus (the organ in which T-cell maturation occurs) revealing increases in thymus size, changes in morphology, and proliferation of a variety of immune cells within the medulla (Franchini & Bertolotti 2014).