The cellular phase involves several types of cells working together to mount an inflammatory response, synthesize granulation tissue, and restore the epithelial layer.
22.
However, epithelial cells require viable tissue to migrate across, so if the wound is deep it must first be filled with granulation tissue.
23.
Small sections of necrotic bone may be resorbed completely, and larger segments may become surrounded by granulation tissue and new bone ( an involucrum ).
24.
When collagen is used as a burn dressing, healthy granulation tissue is able to form very quickly over the burn, helping it to heal rapidly.
25.
It is selectively expressed in reactive stromal fibroblasts of epithelial cancers, granulation tissue of healing wounds, and malignant cells of bone and soft tissue sarcomas.
26.
Bandaging is often used to keep wounds clean, but has been shown to increase the risk of exuberant granulation tissue ( proud flesh ) formation.
27.
The central zone of liquefaction is surrounded in older abscesses by a thickening layer of granulation tissue heavily infiltrated by white blood cells and other inflammatory cells.
28.
At the end of the granulation phase, fibroblasts begin to commit apoptosis, converting granulation tissue from an environment rich in cells to one that consists mainly of collagen.
29.
The initial granulation tissue formed is highly inflammatory with a high rate of tissue turnover mediated by matrix degrading enzymes and reactive oxygen metabolites that are products of inflammatory cells.
30.
Furthermore, the increase in M1 macrophages, blood vessels, and proliferating cells that occur within two weeks of the injury are associated with a formation of granulation tissue.
