OxyFile #142

Physiological effects of tissue oxygenation on wound healing

JoAnne D. Whitney

Heart and Lung
Sept 1989 v18 n5 p466(11) 


Abstract

The availability of oxygen to tissues plays an important role in
the process of wound healing. When skin is damaged, swelling
occurs, fibroblasts (a type of cell) grow, and blood vessels and
connective tissue begin to grow.

During the early inflammatory phase, the process of wound repair
begins with the activation of enzymes and white blood cells which
destroy bacteria and cause blood clot formation. Macrophages
(cells that engulf debris) clear the wound of destroyed cellular
material. The blood flow to the injured area increases, bringing
nutritive substances to the damaged tissue.

Macrophages also stimulate fibroblasts to secrete collagen, a
type of protein that strengthens the tissues. New blood vessels
are formed to continue the supply of nutrients to the wound.
Although the mechanism is not well understood, the wound then
begins to contract and tissue forms from the wound's edge.

Within one to two days, the epithelial cell layer begins to form.
Nutrition, the immune system, oxygen, blood volume, infection,
immunosuppression (caused by drugs or disease) and a decrease in
red blood cells are all influential factors in wound healing.
Oxygen affects the production of collagen, epithelial cell
growth, and the growth of blood vessels. A decrease in the volume
of circulating blood and the concentration of red blood cells can
compromise the amount of oxygen available for wound healing.

Interventions to improve oxygenation and enhance wound healing
include  replacing reduced blood volume, monitoring fluids,
watching for signs of infection, and monitoring the overall
healing progress.

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