TISSUE REPAIR: Abnormalities/ Complications in wound healing

ABNORMALITIES IN TISSUE REPAIR

Complications of wound healing

These can be classified as follows
1. Defects in Healing
a.WOUND DEHISCENCE
b.CHRONIC WOUNDS
Venous ulcers
Arterial ulcers
Diabetic ulcers
Pressure sores

2. Excessive cell proliferation
EXUBERANT GRANULATION
EXCESSIVE FIBROBLAST PROLIFERATION

3. Excessive scarring
HYPERTROPHIC SCAR
KELOID
CONTRACTURE

EXUBERANT GRANULATION
Formation of excessive amounts of granulation tissue
which protrudes above the level of the surrounding skin thereby preventing reepithelization. This is also referred to as PROUD FLESH
Excess granulation tissue should be removed by cautery /surgery to permit restoration of epithelial continuity

EXUBERANT PROLIFERATION OF FIBROBLASTS
Exuberant proliferation of fibroblasts and other connective tissue elements which may recur even after excision. These are referred to as Desmoids

HYPERTROPHIC SCAR & KELOID
Both result in accumulation of excessive amounts of collagen resulting in raised scar. the scar will be within the confines of the original wound and it regresses over a period of time in HYPERTROPHIC SCAR whereas, the scar grows beyond the confines of the original wound and they do not regress in KELOIDS.
The differences are summarized in the illustration below

CONTRACTURES
exaggeration of the normal contraction resulting in deformities of teh wound and surrounding tissues is referred to as CONTRACTURES. These are found in cases of severe burns and are commonly seeen in palms, soles and anterior thorax.