Porth's Essentials of Pathophysiology, 4e

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Cell Proliferation and Tissue Regeneration and Repair

C h a p t e r 4

R E F E R E N C E S 1. Sephel GC, Davidson JM. Repair, regeneration, and fibrosis. In: Rubin R, Strayer DS, eds. Rubin’s Pathology: Clinicopathologic Foundations of Medicine . 6th ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012:83–113. 2. Kumar V, Abbas AK, Fausto N, et al. Robbins and Cotran Pathologic Basis of Disease . 8th ed. Philadelphia, PA: Saunders Elsevier; 2010:79–110. 3. Alberts B, Johnson A, Lewis J, et al. Molecular Biology of the Cell . 5th ed. New York, NY: Garland Science; 2008:1053–1114, 1178–1195. 4. Pajalunga D, Maxxola A, Franchitto A, et al. The logic of cell cycle exit and reentry. Cell Mol Life Sci . 2008;65:8–15. 5. Vats A, Bielby RC, Tolley NS, et al. Stem cells. Lancet . 2005;366:592–602. 6. Körbling M, Estrov Z. Adult stem cells for tissue repair—A new therapeutic strategy. N Engl J Med . 2003;349:570–582. 7. Metcalfe AD, Ferguson MWJ. Skin stem cells and progenitor cells: using regeneration as a tissue-engineering strategy. Cell Mol Life Sci . 2008;65:24–32. 8. Werner S, Grose R. Regulation of wound healing by growth factors and cytokines. Physiol Rev . 2003;83:835–870. 9. Daley WP, Peters SB, Larsen M. Extracellular matrix dynamics in development and regenerative medicine. J Cell Sci. 2008;21(3): 255–264. 10. Goldberg SR, Dieglmann RR. Wound healing primer. Surg Clin North Am . 2011;90:1113–1140. 11. Teller P, White TK. The physiology of wound healing: injury through maturation. Surg Clin North Am . 2009;89: 598–610. 12. Whitney JD. Overview: acute and chronic wounds. Nurs Clin North Am . 2005;40:191–205. 13. Wei L, Dasgeb B, Phillips T, et al. Wound-healing perspectives. Dermatol Clin . 2005;23:181–192. 14. Strecker-McGraw MK, Jones TR, Baer DG. Soft tissue wounds and principles of healing. Emerg Med Clin North Am . 2007;25:1–22. 15. Li B, Wang JH. Fibroblasts and myofibroblasts in wound healing: force generation and measurement. J Tissue Viability. 2011;20(4):108–120. 16. Adamson R. Role of macrophages in normal wound healing: an overview. J Wound Care. 2009;18(8):349–351. 17. Bielefeld KA, Amini-Nik S, Alman BA. Cutaneous wound healing: recruiting developmental pathways for regeneration. Cell Mol Life Sci . 2013;70:2059–2061. 18. Koh TJ, Dipietro LA. Inflammation and wound healing: the role of the macrophage. Expert Rev Mol Med. 2013;13(e23): 1–14. 19. Monaco JL, Lawrence WT. Acute wound healing: an overview. Clin Plast Surg . 2003;30:1–12. 20. Butler PD, Longaker MT, Yang GP. Current progress in keloid research and treatment. J Am Coll Surg. 2008;206(6): 731–741. 21. Burns JL, Mancoll JS, Phillips LG. Impairments of wound healing. Clin Plast Surg . 2003;30:47–56. 22. Wild T, Raharnia A, Kellner M, et al. Basics in nutrition and wound healing. Nutrition. 2010;28(5):562–566. 23. Mechanick JI. Practical aspects of nutrition support for wound- healing patients. Am J Surg. 2004;188(Suppl):52S–56S. 24. Gordillo GM, Sen CK. Revisiting the essential role of oxygen in wound healing. Am J Surg . 2003;186:259–263. 25. Tandara AA, Mustoe TA. Oxygen and wound healing—More than a nutrient. World J Surg . 2004;28:294–300.

SUMMARY CONCEPTS

R E V I EW E X E R C I S E S 1. Following a heart attack, the area of heart muscle that has undergone necrosis because of a lack of blood supply heals by replacement with scar tissue. A. Compare the functioning of the heart muscle that has been replaced by scar tissue with that of the normal surrounding heart muscle. 2. A 35-year-old man comes in with a large abscess on his leg. He tells you he injured his leg while doing repair work on his house and he thinks there might be a wood sliver in the infected area. A. Explain the events that lead to formation of an abscess. B. He is told that incision and drainage of the lesion will be needed so healing can take place. Explain. C. He is reluctant to have the procedure done and asks whether an antibiotic would work as well. Explain why antibiotics alone are usually not effective in eliminating the microorganisms contained in an abscess. ■■ Tissue repair involves regeneration with the same cell type, or when regeneration cannot restore the injured tissue, by replacement with fibrous (scar) tissue. ■■ Cutaneous wound healing occurs by primary and secondary intention and is commonly divided into three phases: inflammatory, proliferative, and remodeling. In wounds healing by primary intention, such as occurs in a sutured surgical incision, the duration of the healing phases is fairly predictable and the edges of the wound are closely approximated. Larger wounds that have a greater loss of tissue heal by secondary intention, a process that is more unpredictable and results in formation of larger amounts of scar tissue. ■■ Wound healing can be impaired or complicated by factors such as malnutrition, poor blood flow, diminished inflammatory and immune responses, infection, wound separation, and the presence of foreign bodies.