The healing period. Types of wound healing, healing process and treatment

31.03.2020

Each of us has injuries from time to time. How to speed up the healing process and, if possible, avoid scars, read in our article.

Injury - It is always a nuisance. Even the slightest scratch can deliver a lot of unpleasant sensations to a person: inflammation, pain, swelling. And if the indicated effects of injuries pass after a while, then scars, alas, remain on long years. It is especially unpleasant if the scars are formed on visible parts of the body, for example, on the face, neck, hands. Appearance, spoiled by the scars often brings a lot of psychological problems, especially women, so following by their beauty.

Fortunately, everything is not so tragic, as it seems at first glance. With a competent approach to the treatment of wounds and abrasion, it is possible to significantly speed up the healing process, as well as avoid the formation of scars.

How to heal wounds?

First, let's figure it out, how does wound healing? Believe me, the deepening understanding of the processes only contribute to the right tactics of treatment. The wound healing process takes place in several stages:

phase inflammation. Immediately after applying injuries, the body begins to fight the problem. Initially, a tomb is formed in the tissues to stop bleeding. On the other hand, the body needs to constantly fight microorganisms that may fall into the open wound. The whole process is accompanied by inflammation - the process in which immune cells are involved in the place of injury, and the swelling is formed, which presses on the nervous endings, thereby causes pain. Phase inflammation can last up to 7 days. Already on the 7th day, the wound begins to fill with a granular tissue - a connecting tissue that is formed during wound healing;
phase proliferation. It approximately starts from the 7th day and can last up to 4 weeks. In the proliferation phase, the wound is actively filled with a connecting granulation tissue, which is based on collagen. Also, the wound is filled with capillaries and cells of inflammation. So the young scar is formed. At this stage, the scar is easily stretched. Because of the large content in it vessels, the scar has a bright red color, which makes it easily noticeable;
scar formation phase. The scar starts to form about the 4th week, and this process can last up to 1 year. The bright red scar formed at the proliferation stage starts pale, and the scar becomes less noticeable. As a result, the place of the lesion is finally filled with connecting and epithelial cloth. Primary collagen is replaced by a coarse collagen. Thus, a scar is formed, which takes the final (completed) view.

Fast healing

Parallel wound healing takes place in 2 stages: hydration and dehydration. The wound hydration phase is the period when the wound remains wet. Accordingly, the stage of dehydration is the time when the wound remains dry. In this regard, in order to achieve early healing, it is important to use wound-healing drugs (D-Panthenol, etc.). It should be borne in mind that at the hydration stage, the wound is necessary moistening and regular cleansing. And at the stage of dehydration, the wound requires protection and nutrition of the formed tissues. Therefore, it is very important to use invalid drugs already on the "wet" stage. So the wound will close faster, in addition, the risk of infection of the wound will significantly reduce.

In addition, accelerated wound healingAs a rule, does not lead to the formation of scars, either minor scars may form. Well, if the scars still formed, for example, with deep cuts, or burns, then for this case there are funds. In pharmacies can be purchased special means (Ointment, gels) preventing the appearance of scars. However, it is important to apply them immediately after the wound will heal. Thus, in the treatment of scars, you will achieve the maximum effect.

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In medicine, there are three main types of wound healing: healing under the lap, as well as the method of secondary and primary tension. A certain method of healing is always chosen by the doctor, based on the patient's condition and the features of its work. immune system, character of the resulting wound, as well as the presence in the affected area of \u200b\u200binfection. The stages of wound healing, and more precisely their duration depends directly on the type of injury and its scale, as well as on the type of healing itself.

In this article, you will learn everything about the type of wound healing and their characteristics, what are the features and how to properly care for the injury after the healing process.

Healing by first intention

This type of regeneration is the most perfect, since the entire process passes throughout a short period of time, while it is formed quite thin, but very durable scar.

As a rule, the primary tension is healing wounds after operations and imposing seams, as well as minor damage after cuts, if the edges of injury do not have strong discrepancies.

Healing wounds this way is possible in the absence of inflammatory processaccompanied by fitting. The edges of the wound are tightly connected and fixed, resulting in normal and fast healing Wounds without the formation of a large number of coarse scar tissue.

Only a thin scar remains at the site of the wound, Which in the first time after education has red or pink color, but in the future gradually brightens and acquires almost a common tone with the skin.

The wound heals the primary tension in the event that its edges completely come closer to each other, while there are no areas of necrosis between them, there are no signs of inflammation, and damaged tissues completely retained their viability.

Secondary tension

The secondary tension is mainly healing wounds that cannot be sewn and those who were not sewn on time due to the fact that a person later turned to doctors. The secondary tension is healing and wounds in which the process of inflammation and the formation of pus is actively developing. In this case, the method of healing in the cavity of the wound first develops a granulation tissue, gradually filling out all available space, forming a sufficiently large and tight scar from connective tissue. Subsequently, this fabric is covered with epithelium outside.

Processes secondary healing Usually proceed against the background of quite intensive inflammation caused by the primary, as well as secondary infection, and is accompanied by the separation of the pus.

The type of secondary tension can be used for wound healing, having a strong discrepancy between the edges and a significant wound cavity, as well as for those injuries, in the cavity of which are non-shine fabrics or foreign bodies, blood clot.

Also, this technique is resorted in cases where the patient has hypovitaminosis, the overall exhaustion of the body, the processes of metabolism are violated, due to which there is not only a decrease in the protective forces of the body, but also the intensities of the natural processes of tissue regeneration.

Granulation tissue that develops in a wound cavity has for general process Healing and the body as a whole is very important biological significance. It is a kind of physiological, as well as a mechanical barrier, which creates an obstacle to the body of the body of toxins, microbes from the cavity of the wound and the products of the decay of the inflammatory process, which are poisonous for the body.

In addition, the granulation fabric highlights a special wound secret, which contributes to a more rapid wound cleansing in mechanical plan, and also has a natural bactericidal effect, which creates an obstacle to the spread of bacteria and other pathogenic microorganisms from a damaged area on the skin and healthy fabrics.

It is with the help of the granulation process in the wound cavity there is a separation of dead tissues from alive while filling the damaged space.

Of course, all the protective properties have only granulation tissue, not affected by damage, so when changing the dressings it is very important to observe maximum caution and accuracy in order not to apply additional damage.

Healing under the lap

This type of healing is usually restored by scratches, minor wounds, abrasions, burns, small and shallow wounds, as well as breakdowns, ulcers and other skin damage.

In the process of healing on the surface of the ranks or other damage, a crust is formed, Having first red, and, then, a dark brown color, which is called Strap. This formation consists of lymph, rolled blood and wound exudate, mixed together, and closed the surface of the damage to the formed substance.

Strap is a sufficiently dense education, which perfectly protects the wound from pollution, penetration of malicious microorganisms, mechanical damageAt the same time he holds together the edges of injury, providing their relative immobility.

Treatment of small abrasions and cuts

Absadins and various small wounds can be processed and treated at home, on their own, but necessarily observing all the rules of care and applying the right funds.

First of all, when you receive any wound, it is necessary to rinse with water with soap to clean from contamination and the microorganisms caught inside.

After that, the wound should be dryed up with a napkin and with a gauze swab processing damage to the pharmacy solution of hydrogen peroxide, gently wasting the surface.

It is not necessary to cast a hydrogen peroxide on the wound directly from the bottle. This tool allows not only to efficiently disinfect the surface of injury and the skin around it, eliminating almost all types of malicious microorganisms, but also contributes to stopping bleeding.

Then best impose a sterile bandage. If the wound is completely small or damage to a scratch or small abrasion, you can fold a piece of bandage in the size of the injury or take a cotton disk, to impregnate them with a solution, for example, impose on the wound and secure the plaster or bandage. If the bandage is impregnated with blood, it must be changed to fresh, repeating the processing of injury.

Change the bandage impregnated with blood is necessary in order to continue when replacing the dressing material, it is randomly not constructed by blood clots formed on the surface of the wound, which will later become a stamp.

After the crust formation, the bandage should be removed and left damage to open. Wounds under the lap is best and much faster in the air.

Care after healing

After the formation of the stamp on the surface of the damage, which indicates the beginning of the normal healing process, it is very important to ensure that the crust is not injured with any careless movement.

In no case can you try to sink Strup ahead of time when new fabrics have not yet been formed under it. Such actions can lead not only to the penetration of infection and an increase in the timing of the restoration of damaged tissues, but also to the formation of a scar that will require treatment and adjustment. After the formation of a full-fledged Strip tissue will disappear independently.

It is important that the surface of the strip always remains dry. If the crust is wetting, for example, when washing hands or body, it should be dried immediately with a paper napkin.

After the Strip disappears, you can use various ointments, creams or folk remedies To accelerate the formation of the epithelium at the site of ex-injury, as well as to mitigate and moistening young fabrics and preventing the formation of a serious scar.

Restoration of damage

The periods of recovery of any injury are largely dependent on its features, location, location sites, depths, sizes used by the method of healing, medical preparations, correctness of the care, timeliness of treatments and shifts of the dressings.

The healing method plays a significant role in the healing process and recovery time.

If the wound is healing the method of primary tension, it is clean, there is no inflammatory process in it, then healing occurs in about 7 to 10 days, and the restoration of tissues and their strengthen occurs in about a month.

If the infection in the wound and the inflammatory process with pronounced suppuration is developing, the healing occurs according to the secondary tension method and the recovery time is delayed. In this case, the deadlines of the full healing will be individual, since much depends on the state and correctness of the work of the patient's immune system, having diseases endocrine system And any ailments in chronic form.

If the human body is weakened and there are violations in the metabolism processes, then the recovery time in the presence of the inflammatory process can be very strongly delayed and make up several months.

The healing rate of wounds under the screens is primarily depends on the state of the immune system and from the correctness of the injury. It is very important not to skip the resulting crust, but to wait for it to disappear on themselves after the end of the regeneration process of new tissues.

With the help of special preparations, such as various antiseptic solutions, treatment of powder form, as well as gels, creams and ointments in many cases, it is possible not only to significantly speed up the recovery time, but also make the scar after healing, it is much less, softer, Lighter or not formed at all. For the same purpose you can apply folk MedicineBut it is important that only a qualified doctor make any appointment in the treatment of wounds.

What to do with the suppuration and microbial infection of the wound

If the infection has penetrated into the cavity, the inflammatory process will begin in it, the intensity of which primarily depends on the overall state of human health, as well as from the type of microorganisms that have penetrated into the wound cavity.

At the beginning of the suppuration, the wounds should often process, changing the dressings at least twice a day, but if the dressing material is polluted faster, the banners change more often, as needed, each time carrying out the wound processing.

When changing the dressings, the surface of the wound and the skin around it is necessarily treated with antiseptic solution, after which, if necessary, special ointments are applied, helping not only to fight microorganisms, but also to eliminate inflammation, swelling, accelerate the cleansing of the wound cavity, and maintain the required moisture balance in the wound, Not allowing its cuts.

It is important correctly and timely dressing up Using sterile tools, sterile materials, the right means to eliminate inflammation and acceleration of healing, as well as, observing the rules for changing the dressings.

Early healing period(the first 12 hours after the injection of the wound) is mainly characterized by blood bunch On the surface of the wound and the initial inflammatory reactive phenomena (leukocytar infiltration around the vessels, in the interclaid spaces, in the fibrin clot; circular cell infiltration with single-core cell elements of perivascular spaces and wound edges).

The clinically inflammatory response during this period is not yet expressed.

Degenerate (approximately 5 - 8 days) is characterized by necrotic changes in damaged tissues, inflammatory edema of the edges of the wound, active phagocytosis, the formation of purulent exudate. In parallel with this, the purification of wounds from degeneration and necrosis products is gradually occurring, a decrease in polymorphic-nuclear leukocyte infiltration and proliferation of large single-core cells (polyblasts).

Clinically for this period is characterized by the development of the painting of inflammation with all the typical manifestations: pain, hyperemia, lymphangitis and regional lymphhadenitis, local and overall increase in temperature, purulent separated.

Regenerative healing period wounds (Approximate duration - 30 days) is divided into 3 phases.

First phase It is characterized by the development of newly formed vessels, the release of the wound from necrotic tissues, the formation of granulation tissue. Phagocytic activity in the wound and leukocytosis of blood increases. The number of microorganisms in the wound decreases, the virulence falls. Clinically decreases purulent separated from the wound, and the overall state of the patient is normalized.

Second phaseit is characterized by the further attenuation of the inflammatory response and the development of regenerative processes: the granulation tissue fills the wound, fiber junction fabric is formed. The number of bacteria in the wound decreases progressively, the number of leukocytes decreases, differentiated cells of the type of fibroblasts appear. Clinically in this phase eliminates the edema of the edges of the wound, the epithelization begins.

Third phase (Final) is accompanied by the filling of the entire wound cavity with a regenerator consisting of a young connective tissue. A slight purulent discharge is clinically noted, a rapid decrease in the size of the wound due to the editing of the edges and epithelization of the wound defect is occurring.

It should be noted that the separation of wound healing processes for certain periods is largely conditional, since they are not strictly followed by one by one, but develop in parallel. However, certain processes prevail at different stages. On the speed and fullness of healing of purulent wounds affect local conditions in purulent focal And the overall condition of the body, which may be favorable or unfavorable.

From local conditions that contribute to accelerated wound healing, You can call good blood supply to be innervation. Thus, wounds on the face and scalp in connection with good blood supply to heal faster (however, the purulent process is more dangerous due to the features of the structure of subcutaneous fiber and venous collaterals). On the contrary, they slow down the healing of the wounds such local factors, such as the disassembly and bundle bundle, the presence of pockets, sequesters of soft tissues, foreign bodies, closely located purulent foci, as well as additional infection of the wound.

General state The body of the child is determined by the normal function of its organs and systems, as well as age. Well-developed, physically strong children wound healing is faster. Transferred sharp infectious diseases and chronic depleting diseases (hypotrophy, rickets, diabetes, avitaminosis, etc.) slow down the reparative processes. In breast, and especially in newborns children, healing processes acquire a protracted character, which explains the reduced resistance to infection and the deficiency of the plastic material.

Treatment. In the outpatient and polyclinic conditions, small wounds are treated, which, as a rule, are not accompanied by general symptoms.

Principles of treatment of purulent wounds are in accordance with the teachings on wound healing processes. Therapeutic measures should contribute to the fastest flow of the natural process, so when building a treatment plan necessarily takes into account the period wound process and provide local and general activities that improve the conditions for regeneration. These events are somewhat different in different periods of wound healing.

IN early period treatment Wound wounds, essentially, comes down to the prevention of suppuration.

In the degenerate-inflammatory periodWhen the active operation of the microbes and the melting of dead cells and tissues prevails, it is important to suppress the activities of microorganisms and promote the fastest purification of the wound.

These targets are responsible:

1) antibacterial therapy and an increase in the protective forces of the body;
2) strengthening hyperemia and exudation in the wound, as well as the creation of a reliable outflow of wound content;
3) peace of the patient organ and careful attitude to the tissues.

Among antibacterial agents Antibiotics received the greatest distribution. Due to the advent of penicillically resistant forms of microbes, preference is given to antibiotics wide spectrum Actions, when choosing which are guided by the sensitivity of the flora, extinguished from the wound. Antibiotics are used in the form of irrigation or slip the affected surface with a solution of a particular preparation with novocaina. From other antibacterial methods, the Vishnevsky method can be called, which is widely known for surgeons and is based on the use of an ocean dressing and a novocaine block. When infected with the wound with a blue rod, a 3% solution of boric acid is used. Together with antibacterial therapy, pay attention to the increase in the protective forces of the body.

An important factor accelerating wound cleansingis an increase, gain strengthening of the wound content. This is achieved by the use of dressings with a hypertensive solution of sodium chloride (5 - 10%), magnesium sulfate (25%), grape sugar (20 - 25%). Enhanceing hyperemia and exudation in the wound, hypertensive bandages due to osmotic action simultaneously contribute to the edge of the wound separated into the bandage. Exammed evacuation of exudate is achieved by drainage. In children, we usually use thin strips of glove rubber. Returning necrotic tissues and acceleration of infiltrate resorption contributes to the use of a high frequency electric field (UHF). The procedures are carried out daily until the wound cleansing in oligothermal and low-voltage doses of 5 to 10 minutes, only 7 - 8 times.

The patient's peace is created by immobilization. Daily frequent dressings should not be made, with the exception of those cases when this requires the interests of the method (for example, the presence of a drainage that needs to be monitored or deleted).

In the regenerative period, When the inflammatory response subsides, the virulence of infection is weakened, granulation develops, the fight against the infection is no longer important, as in the previous period.

Therapeutic measures should be aimed at creating optimal conditions for regenerative processes. This goal is responsible:

1) wound protection against damage;
2) The use of funds reinforcing the regeneration process.

Granulation, which performs the wound, serve as a protective barrier that prevents the penetration of microbes into the inner medium of the body, and the wound discharge has bactericidal properties. However, the cells and vessels of granulation tissue are easily wounded. Minor mechanical or chemical impact Holds them and opens the entrance gate of infection. Therefore, the wound is protected by a bandage, and the damaged organ is immobilized (the latter mainly relates to the brush, foot). In the regenerative period, hypertensive and antiseptic bandages cannot be used, which also damage granulation. We attach great importance to the rare change of dressings (1 time in 4-5 days).

To accelerate, stimulate healing processes A lot of money has been proposed. We mention only those who find the greatest use when outpatient treatment infected wound. In the first phase of the regenerative period, the ointment of Vishnevsky, Balzam Shostakovsky, blood and blood preparations are very valuable funds that are favorable for healing. whole blood, plasma, serum), as well as ultraviolet irradiations that stimulate granulation growth. In the process of treatment, it is necessary to reasonably apply stimulating agents, for the excess growth of granulations delays the epithelization of the wound surface. Excess granulations are removed by surface treatment with a 5% solution of silver nitric acid (Lapis) or mechanically.

When a normal granulation tissue appears in the second and third phase of the regenerative period, there are randoms with indifferent ointment ( fish fat, Vaseline oil, etc.). When the epithelial delay, the wound healing accelerates the rapprochement of its edges with a strip of sticky plaster.

In addition to the methods listed above, the complex of therapeutic measures can be applied and surgical methods (rapprochement of edges wound seams). In the degenerative-inflammatory period, the imposition of seams is contraindicated, but after purification of the wound and the elimination of the inflammatory process, indications may be indicated to the imposition of secondary seams (in particular, after the suppuration of the operating room). The seams imposed on a granulating wound with movable non-fixed edges without the presence of scars (after 8 - 10 days after injury), called the early secondary seam, and imposed on a granulating wound with the development of scar tissue after excision of its edges and the bottom (after 20 or more days) - Late secondary seam. The most effective early secondary seams.

In children of wounds of more than 5x5 cm, Localized on the head, in some cases are not prone to independent healing. In such cases, skin plastic is used (in the hospital).

In newborns and children of early breast-age Head wounds (nipzovaya, after vacuum extraction of the fetus, incision with infected cheefalgemate) are often complicated by contact osteomyelitis, bones of the skull of the skull. In the process of treatment, such wounds, especially with a delayed healing, radiological control is necessary. The patient is in a timely manner in the hospital. After the suffered osteomyelitis, there are sometimes large defects in the sign of the skull, which pose a threat to the child's life when it starts to walk and hit his head. Protective bandages are needed.

Wound healing is a dynamic process consisting of three overlapping stages: inflammation, formation of granulation tissue, ripening or leather restructuring. The contribution of each of these stages to the healing process depends on the depth of damage.

Shallow wounds. Shallow wounds capture the epidermis and the upper layers of the dermis. Skin appendages (hair follicles, sweat and sebaceous glands) It is saved. Thromb formation, inflammation and formation of granulation tissue are expressed slightly. The healing of the shallow wounds is based on the epithelialization due to the preserved appendages of the skin and the regional epidermis, which ultimately leads to a complete and rapid restoration of the skin with imperceptible scars or at all. In place of the wound can remain hyper- or hypopigmentation.

Deep wounds. The required stage in the healing of deep wounds is the formation of a thrombus to stop bleeding from relatively large vessels of deep layers of dermis. Inflammation and formation of granulation tissue are important stages of healing along with skin tension, which ensures rapprochement of the edges of the wound, contributing to epithelization. Since skin's appendages are damaged, the epithelization of deep wounds occurs only due to the edge of the epidermis and lost tissues are replaced by the scars.

To understand the pathogenesis of scarring, it is necessary to know how wounds are healing in the norm.

Stage of inflammation

The first thing happens during wound healing is the formation of hematoma. This ensures cessation of bleeding from damaged vessels and the creation of a barrier impeding the injection of microorganisms. Thromb is a temporary matrix in which inflammatory cells migrate. In the destruction of platelets, many growth factors are distinguished, incl. Transforming growth factor (TFR-β1), an epidermal growth factor, an insulin-like growth factor of type 1 (IFR-1) and a thrombocyte growth factor, which attract inflammation cells, contribute to the synthesis of extracellular matrix and spacing the vessels.

A number of other signal molecules, such as fibrinolysis products, attracts neutrophil and monocytes to the wound. These cells come from blood flow by diapelling through endotheliums adjacent to the wound of capillaries. The main function of neutrophils is phagocytosis and the destruction of microorganisms inside the cells. In addition, neutrophils produce inflammation mediators, under the action of which keratinocytes and macrophages can be activated at this healing.

At the end of the acute inflammatory response (after 1-2 days), the monocytes migrated from the blood flow become macrophages and destroy the remaining microorganisms and dead cells. These macrophages also serve as a source of growth factors and inflammation mediators, in particular the platelet growth factor, which attract fibroblasts to the place of damage.

Stage of Proliferation

Fresh granulation tissue is very rich in vessels and cells. Since the healing of deep wounds is not enough single epithelization, already at the first stages begins the proliferation of fibroblasts adjacent to the wound areas of the dermis. Fibroblasts migrate into the wound, the subtle extracellular matrix, consisting of fibrin, fibronectin, vitrenectin and glycosaminoglycans. In the fresh granulation tissue, the collagen III ratio to the type I collagen.

In response to the action of growth factors, the proliferation of keratinocytes and fibroblasts begins in the wound. As the granulation and the appearance of excess collagen matrix appearance, the number of cells decreases by apoptosis. Due to what apoptosis is included - unknown. Under the action of substances that stimulate angiogenesis, which serve as inductors of the endothelium growth factor, TFR-β1, angiotropine and thrombopondin, vessels begin to grow into extracellular matrix.

Myofibroblasts contribute to the rapprochement of the edges of extensive wounds, which reduces the amount of granulation tissue necessary to fill the wound cavity, and reduces the area of \u200b\u200bepithelization. Due to the contracting proteins of actin and desphams, the fibroblasts contribute to the edges of the edges of the wound. The mechanical voltage arising after the edges of the wound closed, gives a signal to cease tension.

Epithelialization begins after a few hours after the wound appears. Migratory keratinocytes activate the plasminogen tissue activator and the urogase and increase the number of receptors to the urchinase, which, in turn, contributes to the fibrinolysis - an important stage required for migration of keratinocytes. To go through the temporary matrix formed by trombum, keratinocytes form additional Fibronctin and Collagen receptors. Migration of keratinocytes and epithelials contributes to the tension of the edges of the wound.

Stage of ripening and restructuring (full healing)

At the rearrangement stage of the collagen surplus and temporary matrix are removed by tissue enzymes, inflammation cells leave the wound. During the ripening of the scar, an equilibrium between the processes of destruction of the time matrix and the collagen synthesis are occurred.

On the one hand, fibroblasts are synthesized collagen, contractile proteins and extracellular matrix, on the other - fibroblasts, fat cells, endothelium cells and macrophages allocate a number of enzymes (matrix metalloproteinases) necessary for destruction and restructuring. The equilibrium between these proteinases and their tissue inhibitors plays an important role in the restoration of damaged tissues.

Interferons produced by T-lymphocytes (interferon-γ), leukocytes (interferon-α) and fibroblasts (interferon-β), prevent the development of fibrosis and suppress the synthesis of collagen and fibronectin fibroblasts.

The rearrangement process continues from 6 to 12 months, but can stretch for years. The strength and elasticity of the scar is usually only 70 - 80% of those intact skin, so the scars are more susceptible to repeat injury.

Factors affecting wound healing and scar education

Age. Unlike adult people, the wounds on the skin of the fetus are healing quickly and without the formation of scars. The mechanism of Crabless healing is unclear, however, it is known that inflammation is expressed weakly, in the wound content there is a large amount of hyaluronic acid, the collagen fibers are stacked in a certain order.

The organism of the fetus is significantly different from the adult organism. The main difference is in the peculiarities of tissue oxygenation: the oxygen content remains relatively low the entire period of intrauterine development. Inflammation in the wounds of the fetus is taller due to neutropenia. With the development of the immune system of the fetus, the inflammatory response becomes more pronounced, and on the site of wounds may form scars.

The fetal skin is constantly washed by warm sterile amniotic fluid, which contains many growth factors. But one of these Crabless healing is not explained. In experiments on the fruits, wound isolation from amniotic fluid With the help of silicone bandage, it did not prevent Crabless healing; On the other hand, the skin of an adult leaned with the formation of a scar, despite contact with amniotic fluid.

The high content of hyaluronic acid in the extracellular matrix increases the mobility of cells, enhances their proliferation, and therefore restoring the damaged area. This allows you to consider hyaluronic acid by the main factor of Cubbar Healing. In the wounds of fruits, a glycoprotein was found, absent in the wounds of adults. This glycoprotein stimulates the synthesis of hyaluronic acid. In addition, it is assumed that the long-term presence in the wounds of fruits contributes to the ordered collagen deposition when healing them. When processing hyaluronic acid perforated eardrum The rats not only restored faster than that of control animals, but also the scar tissue in the place of damage was less, and the fibers of collagen were arranged ordered.

Fast epithelization of wounds in the fetal may be due to the early accumulation of fibronectin and tenscine in the wound content. Fiber fibroblasts and adults are different. Fiber fibroblasts at the beginning of the intrauterine development produce more collagen III and IV types, while adult fibroblasts are mainly type I collagen. In addition, fiber fibroblasts are capable of simultaneously proliferate and synthesize collagen, and in an adult proliferation of fibroblasts precedes collagen synthesis. Thus, in adults in the healing of the Russian Academy of Sciences, the appearance of collagen deposits is somewhat late, which leads to the formation of scars. Tension of the skin in Crabless healing role does not play, because Full wounds are practically deprived of myofibroblasts.

A key role in the restoration of damaged tissues and the formation of scars belongs to inflammation. The fetus in the absence of inflammation wounds are healing without scars. It is believed that with age healing wounds deteriorates. As the body agrees, the inflammatory reaction is reduced by the weakening of the macrophage function and T-lymphocytes, the loss of reactivity and the mobility of fibroblasts, reducing the number and other distribution of growth factors and their receptors, incl. TFR-β receptor. All this can serve as an explanation of the speed difference and the quality of wound healing at different ages.

Although wounds in older persons heal slower, they increase the quality of the scars, which may be due to a decrease in the level of transforming growth factor (TFR-β) in damaged skin. It is also possible that fibroblasts of the fetal subtype appear in the wounds of the elderly, which leads to healing of wounds, like the fetus. Reducing the level of hormones, in particular estrogen, in menopause also can also contribute to a slower healing of wounds and reduce the scarring.

Estrogens. In vitro studies have shown that sex hormones have an impact on such important stages of wound healing as inflammation and proliferation. Estrogens regulate the production of TFR-β isoforms and the formation of their receptors, which plays a prominent role in the development of fibrosis and the formation of scars. In healthy women in postmenopausus, wound healing slows down, but the quality of scars increases, which is associated with a decrease in the level of TFR-β1 in the wounds.

Against the background of substitution hormone therapy, the wounds begin to heal faster, which suggests direct or indirect regulation of healing by sex hormones. Studies have shown that women in menopause replacement hormonal therapy For 3 months. Accelerates epithelization and collagen deposition in the wounds.

The presence of estrogen receptors on the surface of fibroblasts indicates the possibility of direct regulation of the function of these cells by estrogen. In addition, estrogens increase the level of TFP-β1 in vitro.

These data suggest the participation of estrogen in the regulation of the production of fibroblasts of the skin and TFR-β1. Finally, it was noted that the systemic administration of estrogen antagonists inhibits healing of wounds in humans. Preliminary study of the scars in women who received wounds against the background of the introduction of the Estrogen antagonist Tamoxifen showed that these scars were better qualitythan scars left after healing of the same wounds in women who have not been injected with tamoxifen.

Heredity. There are data on the existence of a hereditary factor that affects the process of wound healing, activating an abnormal (pathological) scarring, which leads to the emergence of hypertrophic and keloid scars. It was reported both about autosomal dominant and on an autosomal-recessive type of inheritance of keloid scars. Often, the keloid scars are also observed in relatives of the patient with similar scars. In addition, the prevalence of keloid scars is significantly higher among the population with dark skin, reaching 4.5% of Africans and Latin Americans. The frequency of keloid scars in the HLA-β14 and HLA-BW16 carriers, in persons with a group of blood A (II) and suffering from Rubinstein-Teyby syndrome.

There are several stages of tattoo healing, each of which is distinguished by certain rules for leaking damaged skin. For a long time remains a spectacular and beautiful decoration for a long time, you should not neglect the tips of the tattooer. Strict adherence to his recommendations is the main key to the fact that you will not need a correction. What should be known to avoid the deformity of the tattoo and keep his durability?

First stage

The quality of the tattoo is half depends on the correct care in the first days after the session. The application of permanent pattern is a mechanical intervention in the human body, which cannot pass painlessly and without a trace. After the procedure on the body there are small microcracks, through which Sukrovitsa stands out. Thus, the process of healing and cleansing the skin, which launches the lymphatic system.

At the first stage of healing, the body portion with a tattoo swells and releases in the form of a sticky fluid with an admixture of ink. Many primarily think that the drawing is simply spread and washed off, but it is not. This is the normal response of the body to a similar procedure. In the cabin, the tattooker processes the place of application of healing ointment and turns the protective film. The film is not recommended to remove during the first day. At home you need to take warm (not hot!) Souls, gently rinse the wound with antibacterial soap and leave dried. In no case can not rub the drawing with a washcloth, a towel. After washing on the tattoo, healing anti-inflammatory cream should be applied.

Second phase

On the second day, the tattoo healing suucaria disappears, the tumor passes. The skin at this stage is tightened, becomes dry and dehydrated. Why is this happening? The fact is that ink is perceived by the body as foreign body. It is necessary that they come across and did not turn back. In this period, it is necessary to actively process the drawing with healing ointments. It is recommended to avoid contact of the body with clothing, as friction does not contribute to the healing of the tattoo. If you need to go outside, the place of application is desirable to wrap a protective or ordinary food film. At home during the second stage of healing, it is better to leave the tattoo open to the skin breathe.

Third stage

Usually on the third day on the tattoo, a crust is formed. The skin begins to peel, white or colored flakes appear. The fact is that the ink remains in the lower layer, the derma, and the epidermis, that is, the upper layer is updated and restored after the procedure. Such a reaction of the body provokes a strong itching and unpleasant sensations. In no case should you scratch the tattoo and sink a crust. By this, you will significantly hurt the drawing and increase the healing time. You can easily pat on the body on the body and continue to process the ointment area. Antiseptic solution Sinaflane will also help reduce itching. At this time, it is advisable not to visit gym, solarium, limit the time staying in the open sun and reduce physical exercise. Do not be afraid if the tattoo is a little fade and loses the brightness. It will pass after full healing

Duration of healing

The tattoo healing time for each person individually and depends on the following factors.

Place application

Buttocks, chest and stomach are healing faster. The recovery period takes from 4 to 7 days. Plots with a small amount of subcutaneous fat (spin, ankle, neck) can be wrapped up to 2 weeks.

Tattoo volume

Large tattoo is usually applied in several stages, so complete healing occurs in a month. This is especially true of portrait photos in the style of realism or Tattoo Blackworg, where a large amount of ink is used for full hatching pattern. Small and middle tattoo are restored faster, since the area of \u200b\u200bthe body is small.

Thickness and depth of lines

Thin neat lines are not very injured and restored faster, deep, wide and thick - longer: 1-2 weeks.

Determine whether the tattoo healed, you can spend on her hand. If the drawing is homogeneous, without coarse and husk - the recovery process was successful.

Healing Mazi.

After the session, the tattoo needs proper care. Tattooer When completing the work processes the place of application of anti-inflammatory ointment, which removes swelling. Next, this procedure must be done at home to speed up the process of regeneration. The most efficient and recommended drugs include the following.

Remember that during the period of regeneration of the damaged area (that is, during the entire three stages listed above), it should be completely abandoned with cosmetic creams for hands and even a children's cream. The fact is that they contain additives, flavors and essential oilswho do not contribute to healing, but on the contrary, injured the skin.