The proliferative phase of wound healing occurs how long after the injury?
a. Normal wound healing follows a predictable pattern that can be divided into
i. Hemostosis and inflammation
iii. Maturation and remodeling
b. Initial phase causes platelet adhesion and aggregation and the formation of clot in the surface of the wound leading to the inflammation.
c. In proliferative phase there is formation of the granulation tissue, proliferation and migration of the connective tissue cells,and re-epitheliasitation of the wound.
d. In the maturation, ECM deposition, tissue remodeling and wound contraction occurs.
e. The proliferative phase is the second phase of would healing and roughly spans day 4 through 12. it is during this phase that tissue continuity is re-established.
f. Neutrophils are largely replaced by macrophages in this phase.
g. Macrophages are the key cellular constituent of the healing and tissue repair.
h. Macrophages clear extracellular debris, fibrin and other foreign material at the site of repair. Migration of the fibroblast occur in this phase.
i. Fibroblasts are driven to the site by chemokines, TNF,PGDF,TGF-b,FGF.
j. Collagen fibres present in this phase and initially they are vertically placed.
k. Later they bridge the incision once subepithelial continuity is achieved.
l. With epitheliasation , collagen fibres become more abundant and begin to bridge the incision.
m. TGF-b is the key fibrogenic agent. .