1. Chapter
Tissue repair
Department of pathology longjie

2. Repair (修复）
Would healing （创伤愈合）

3. Repair (修复）
As cells and tissues are being injured, events that contain the damage and prepare the surviving cells to replicate are set into motion.

4. Repair begins very early in the cell injury, and involves two processes:
1. Regeneration (再生）
2. fibrosis （纤维性修复）

5. regeneration 再 生 Regeneration of injured tissue by
再 生
Regeneration of injured tissue by
parenchymal cells of the same type .

6. types
Physiological regeneration
Pathological regeneration

7. Proliferative potential of different cell types
Labile cells
不稳定细胞
稳定细胞
Stable cells
Permanent cells
永久性细胞

8. Labile cells stratified squamous surfaces
Continuously dividing and dying
Surface epithelia
stratified squamous surfaces
cuboidal epithelia
columnar epithlium
transitional epithelium
Hematopoietic cells

10. Stable cells Quiescent but can rapidly divide in response to injury
Parenchymal of solid glandular tissues: liver, kidney, pancreas
Endothelial cells lining blood vessels
fibroblast
Smooth muscle connective tissue

12. Permanent cells
Be terminally differentiated and nonproliferative in postnatal life
neurons
Cardiac muscle cells

13. Regeneration of different tissues

14. 毛细血管的再生 angiogenesis

18. fibrosis
纤维性修复
Replacement by connective tissue, resulting in a scar.

19. types
Granulation tissue (肉芽组织)
Scar (瘢痕)

20. Granulation tissue Gross: pink , soft , granular Micro:
proliferation of fibroblasts
new thin-walled, delicate capillaries
inflammatory cells

21. 脚的肉芽组织

22. 肉芽组织

24. Granulation tissue

25. fibroblast

26. signafication risist infection and protect the wound surface；
fill the deficiency and repair the injured tissue；
organize blood clotting, necrotic tissues or abnormal substances

27. scar Gross: tissue shrinkage, pale-gray , hard , lack of elasticity
Micro:
fibroblasts , new vessels avascular
inflammatory cells
collagen synthesis hyaline change

30. effect Good: 1.fill the defect, repair the tissue
2. More tensile strength than granulation tissue
bad: 1.scar shrinkage obstruction of tissue activity
2. Scaring conglutination ( 瘢痕性粘连）
3. Organ cirrosis （器官硬化）
4. Scar hyperplasia （瘢痕增生）

31. A complex but orderly process, involving both parenchymal cells regeneration and the formation of connective tissue scar.(创伤愈合)
Wound Healing

32. Healing of skin wound

33. types Healing by first intention (primary union) 一期愈合
Healing by second intention (sceondary union)
二期愈合

34. Healing by first intention
Healing of a clean , uninfected surgical incision approximated by surgical sutures.
Healing by
first intention
1. Less fibrinclotted blood, granulation tissue and scar
2. Mild inflammation reaction

35. 一 期 愈 合 模 式 图

36. Healing by secondary intention
large tissue defects, infected and irregular incision.
Healing by
secondary intention
1. Much larger amounts of granulation tissue and scar
2. Extensive inflammation reaction

37. 二期愈合模式图

38. Healing of skin wound

39. influences of healing glucocorticoids Mechanical factors radiation Age
infection
Blood supply
nutrition

40. Healing of bone fracture (self – study)

41. thanks!