Yadav Rai
INTRODUCTION
The healing process is the body's natural process of regenerating new tissues or muscle fibres. The pain and the swelling are caused by chemicals that are released by the dead and dying cells, acting on the bare nerve ending of pain fibres and the fluid called inflammatory exudates. In the case of a strain, bruise or crush, the local network of blood vessels is damaged and damaged vessels bleed as the oxygenated blood can no longer reach some tissues- so the cells die. When a cell dies, the cell membrane does not remain intact and the contents are released and within 10 or 15 minutes of an injury the damaged soft tissue contains disrupted extracellular tissues, dead and dying cells which release powerful digestive enzymes, and a variable amount of blood. Therefore, when an individual is injured, a set of complex biochemical events takes place to repair the damage and hence, the healing of soft tissues are described in a three-phase process involving Acute response phase, Proliferation and repair phase and Remodelling phase
Stage 1: Acute inflammatory phase
Acute phase is the first stage of an injury and it can take up to 72 hours for the process to start depending on the seriousness of the injury. The features include redness, local heat, swelling, pain and in severe cases loss of function caused by opening of blood vessels and nerve exposure. The local blood vessel (injured area) constriction lasts a few seconds to as long as ten minutes curtailing loss of blood and initiation of clotting. The vasodilatation process takes place due to the presence of heparin and other chemical mediators along with an increased blood flow to the injured region, causes swelling. The blood from the broken vessels and damaged local tissues form a haematoma and with the necrotic tissue (dead tissue) forms the zone of primary injury. The swelling occurs due to increased permeability and pressure increases speeding up to transport of specialist cells such as white blood cells and scavenger cells. These cells engulf and digest the debris and invading microorganism, they also release chemicals that encourage fibroblasts to multiply, and the fibroblasts are the cells, which produce the proteins of repair, especially collagen.