Soft tissue healing is usually divided into three stages, but these can over lap to a certain degree, and time periods are determined by various factors intrinsic and extrinsic to the patient.

 

Inflammatory Phase – day 0 to 7. During this period, the body’s natural response to injury kicks in. There is an influx of white blood cells (the immune response) to the area, and an increased blood supply in general. This assists in the clearing of bacteria, necrotic debris and foreign material. There is much debate over the use of Anti-inflammatory medication during this time, as it would block this important stage. Most experts advise to only use pain medication (analgesics) in the first 24 – 48 hours. Normal responses during this period include swelling, redness, increased temperature over the area, and pain.

 

Fibroblastic Phase – 4/5 days to 2-6 weeks. This is an important period during which the tissue is healing, but very weak. New collaged and scar tissue is being formed, and gentle stress can facilitate the growth. The tensile strength of the scar is only 15% of normal, and too much too soon can set the process back.

 

Remodelling Phase – 6 weeks onwards. During this time the tensile strength of the healing wound increases. The scar tissue is arranged along the lines of stress, but can shorten. Rehabilitation and flexibility is therefore a priority. It is important to remember that different tissues heal faster than others, there is no rule.

 

Reference:
Hardy, M. A. The biology of scar formation. Physical Therapy. 69:1014-1024, 1989.

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