Wound contracture is a process that may occur during wound healing when an excess of wound contraction, a normal healing process, leads to physical deformity characterized by skin constriction and functional limitations. [1] [2] [3] Wound contractures may be seen after serious burns and may occur on the palms, the soles, and the anterior thorax. [2] For example, scars that prevent joints from extending or scars that cause an ectropion are considered wound contractures. [1] [4]
Wound healing is a complex process in which the skin, and the tissues under it, repair themselves after injury. In this article, wound healing is depicted in a discrete timeline of physical attributes (phases) constituting the post-trauma repairing process. In undamaged skin, the epidermis and dermis form a protective barrier against the external environment. When the barrier is broken, a regulated sequence of biochemical events is set into motion to repair the damage. This process is divided into predictable phases: blood clotting (hemostasis), inflammation, tissue growth (proliferation), and tissue remodeling (maturation). Blood clotting may be considered to be part of the inflammation stage instead of a separate stage.
Ectropion is a medical condition in which the lower eyelid turns outwards. It is one of the notable aspects of newborns exhibiting congenital Harlequin-type ichthyosis, but ectropion can occur due to any weakening of tissue of the lower eyelid. The condition can be repaired surgically. Ectropion is also found in dogs as a genetic disorder in certain breeds.
A scar is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs and tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in some degree of scarring. An exception to this are animals with complete regeneration, which regrow tissue without scar formation.
A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation. Most burns are due to heat from hot liquids, solids, or fire. While rates are similar for males and females the underlying causes often differ. Among women in some areas, risk is related to use of open cooking fires or unsafe cook stoves. Among men, risk is related to the work environments. Alcoholism and smoking are other risk factors. Burns can also occur as a result of self-harm or violence between people.
Anasarca is a severe and generalized form of edema, with subcutaneous tissue swelling throughout the body. Causes include liver failure, renal failure, right-sided heart failure, and severe protein deficiency, and capillary leak syndrome. It can also be caused by the administration of exogenous intravenous fluid. C In Hb Barts, the high oxygen affinity results in poor oxygen delivery to peripheral tissues, resulting in anasarca.
A tracheoesophageal fistula is an abnormal connection (fistula) between the esophagus and the trachea. TEF is a common congenital abnormality, but when occurring late in life is usually the sequela of surgical procedures such as a laryngectomy.
Left shift or blood shift is an increase in the number of immature leukocytes in the peripheral blood, particularly neutrophil band cells.
Stewart–Treves syndrome, refers to a lymphangiosarcoma, a rare complication that forms as a result of chronic, long-standing lymphedema. Although it most commonly refers to malignancies associated with chronic lymphedema resulting from mastectomy and/or radiotherapy for breast cancer, it may also describe lymphangiosarcomas that result from congenital and other causes of chronic secondary lymphedema. Lymphangiosarcoma arising from cancer-related lymphedema has become much less common with better surgical techniques, radiation therapy, and conservative treatment. The prognosis, even with wide surgical excision and subsequent radiotherapy, is poor.
A blunt cardiac injury is an injury to the heart as the result of blunt trauma, typically to the anterior chest wall. It can result in a variety of specific injuries to the heart, the most common of which is a myocardial contusion, which is a term for a bruise (contusion) to the heart after an injury. Other injuries which can result include septal defects and valvular failures. The right ventricle is thought to be most commonly affected due to its anatomic location as the most anterior surface of the heart. Myocardial contusion is not a specific diagnosis and the extent of the injury can vary greatly. Usually, there are other chest injuries seen with a myocardial contusion such as rib fractures, pneumothorax, and heart valve injury. When a myocardial contusion is suspected, consideration must be given to any other chest injuries, which will likely be determined by clinical signs, tests, and imaging.
Nodular fasciitis, is a benign soft tissue lesion most commonly found in the superficial fascia. The lesion commonly occurs in the first three decades of life. Upper extremities and trunk are the most common affected anatomical areas. Previous history of trauma may be present. Clinically and histologically, nodular fasciitis may be mistaken for a sarcoma.
Biliary colic, also known as a gallbladder attack or gallstone attack, is when a colic occurs due to a gallstone temporarily blocking the cystic duct. Typically, the pain is in the right upper part of the abdomen. Pain usually lasts from 15 minutes to a few hours. Often, it occurs after eating a heavy meal, or during the night. Repeated attacks are common.
In pathology, Anitschkowcells are often cells associated with rheumatic heart disease. Anitschkow cells are enlarged macrophages found within granulomas associated with the disease.
Obstructive uropathy is a structural or functional hindrance of normal urine flow, sometimes leading to renal dysfunction.
Sulfatidosis is a form of lysosomal storage disease resulting in a proliferation of sulfatide.
Respiratory bronchiolitis interstitial lung disease refers to a form of idiopathic interstitial pneumonia associated with smoking.
Diffuse alveolar damage is a histological pattern in lung disease. It is seen in acute respiratory distress syndrome (ARDS), transfusion related acute lung injury (TRALI) and acute interstitial pneumonia (AIP).
Nonthrombocytopenic purpura is a type of purpura not associated with thrombocytopenia.
Burn scar contracture is the tightening of the skin after a second or third degree burn. When skin is burned, the surrounding skin begins to pull together, resulting in a contracture. It needs to be treated as soon as possible because the scar can result in restriction of movement around the injured area. This is mediated by myofibroblasts.
Verocay bodies are acellular areas between areas of nuclear palisading found in schwannoma neoplasms.
Ultrasonic cavitation device is a surgical device using low frequency ultrasound energy to dissect or fragment tissues with low fiber content. It is basically an ultrasound probe combined with an aspirator device (suction).
A zellballen is a small nest of chromaffin cells or chief cells with pale eosinophilic staining. Zellballen are separated into groups by segmenting bands of fibrovascular stroma, and are surrounded by supporting sustentacular cells. A zellballen pattern is diagnostic for paraganglioma or pheochromocytoma.
Normally, the myofibroblasts appear in the initial wound healing processes and generate contractile forces to pull both edges of an open wound until it disappears by apoptosis. But as an altered regulation of myofibroblast disappearance, they remain in the dermis and continuously contract the scar, eventually causing scar contracture.
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