(WOUND HEALING )
OLEH :
Dr. Asrofi S. Surachman
(Spesialis Bedah Plastik, Rekonstruksi dan Estetik)
FASE INFLAMASI
LAG PHASE
FASE EKSUDASI
( memerlukan waktu 3 sampai 5 hari )
4. FIBROPLASIA
Sebukan jaringan fibroblast ke daerah yang telah mengalami
biological debridement dan sintesa kolagen dimulai. Fibroblast
mempunyai kemampuan kontraksi seperti otot sehingga disebut
myofibroblast. Adanya myofibroblast ini memungkinkan tepi luka
kontraksi mendekati satu sama lain sehingga luka mengecil.
Kolagen disamping disintesa juga didegradasi.
5. ANGIOGENESIS
Pembentukan pembuluh darah baru untuk menghidupi jaringan
fibroblast yang telah terbentuk. Dimulai dengan selapis endothel.
6. EPITELISASI
Epitelisasi terjadi setelah jaringan dibawahnya terbentuk.
Dimulai dari tepi luka dengan sarat jaringan ditengahnya harus lebih
rendah atau sama tingginya dengan tepi luka.
FASE FIBROPLASIA
FASE PROLFERASI
FASE KOLAGENASI
FASE RESORBSI
FASE MATURASI
FASE REMODELING
Platelet-derived growth factor PDGF Platelets, macrophages, endothelial cells, and Fibroblast proliferation, chemotaxis, and
smooth muscle cells collagen metabolism; chemotaxis and
activation of neutrophils, macrophages,
angiogenesis
Transforming growth factor TGF- Platelets, neutrophils, lymphocytes, macro – Fibroblast proliferation, chemotaxis, col -
phages, and many other tissues and cells lagen metabolism, inderect angiogenesis,
and action of other growth factors
Epidermal growth factor EGF Platelets, saliva, urine, milk and plasma Stimulates epithelial cell and fibrolast pro
liferation and granulation tissue formation
Transforming growth factor TGF- Activated macrophages, platelets, keratino – Similar to EGF functions
cytes, and many tissues
Interleukins IL-I Macrophages, lymphocytes, and many other Fibroblast proliferation, collagenase, neu
etc tissues and cells trophil chemotaxis
Tumor necrosis factor TNF Macrophages, mast cells, and T lymphocytes Fibroblast proliferation
Fibroblast growth factors FGF Brain, pituitary, macrophages, and many Fibroblast and epithelial cell proliferation
other tissues and cells stimulates matrix deposition, wound con
traction and angiogenesis
Keratinocyte groth factors KGF Fibroblasts Epithelial cell proliferation
Insulinlike growth factor-I IGF-I Liver, plasma, and fibroblasts Stimulates synthesis of sulfated proteogly
cans, collagen, and fibroblast proliferation
Human growth hormone HuGH Pituitary and thus plasma Anabolism, stimulates IGF-I
Interferons IFN Lymphocytes and fibroblasts Inhibition of fibroblast proliferation and
collagen synthesis
TISSUE INJURY
COAGULATION
Platelets
PDGF, TGF
EGF, TGF
INFLAMMATION
Neutrophils Macrophages Lymphocytes
TGF PDGF, TGF TGF
FGF, TGF IL-2
IL-1, TNF IFN
REPAIR
REMODELING
Fibroblasts Macrophages
V. FAKTOR-FAKTOR YANG
BERPENGARUH :
METABOLISME
MICROENVIRONMENT DARI LUKA
SISTEM IMUNITAS
EICOSANOID, CYTOKINES DAN RADIKAL
BEBAS
INTERVENSI FARMAKOLOGI
BERAT RINGANNYA TRAUMA
VI. PENYEMBUHAN LUKA
PADA JARINGAN SPESIFIK :
TRAKTUS GASTROINTESTINAL
TULANG
TULANG RAWAN
TENDON
LIGAMENTUM
SARAF PERIFER
FETUS
TERIMA KASIH