What is Pathology - How do primary intention wounds heal?
Surgical wounds that are clean heal with the primary intention of healing. The wound goes through various stages in order to heal: -Hematoma (1st day): The wound is first filled with coagulated blood and cell debris. The removal of extraneous material is ensured by an influx of neutrophils, followed by an influx of macrophages on the second day. -Inflammation and early granulation tissue (days 2–3): Macrophages enhance the formation of collagen type III by stimulating the ingrowth of fibroblasts and angioblasts. Epidermal cells construct a bridge across the defect, sealing it off. & Completely developed granulation tissue (days 4–6): Neovascularization peaks, and the entire area appears swollen and red. The granulation tissue contains multiple fibroblasts that rapidly manufacture ECM molecules in addition to numerous freshly created capillaries. -Blanching (week 2): Collagen deposits compress and replace blood vessels over time, reducing blood flow through the healing wound. Macrophages become less prominent, resulting in scar development. The granulation tissue is eventually replaced by fibrous scar during the next few weeks. Collagen type III is gradually replaced by collagen type I during this time, and the wound gains tensile strength. The tissue had regained roughly 80% of its former strength by the third month. & Scar remodeling: This can take several months, during which time the tissue gains increased tensile strength.
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