Wound healing consists of two phases: proliferation, which leads to wound closure new tissue growth and remodeling phase where the excess binder is removed and the wound heals ideally so that the wound site is not known. The same process whether it's an injury or surgery. Immediately after the injury also plays a role in the immune system that cleans the wound and prevents infections. About whether the wound will heal poorly or well, often makes blood supply. Its renewal occurs by growth of new blood vessels and capillaries, which may limit the total rate of healing.
Scar healing occurs at all times, but may not always be visible. If wearing tails injuries fit properly (or workbooks), and the growth phase of healing will quickly create less excess binder visible as a scar. I internal injuries (torn muscles, tendons and other organs) heals scar formation, but that is hidden beneath the surface. For fractures resulting bone svalek proliferative phase, which is equivalent to bone scars. As well as scars and bone svalek with time decreases and is remodeled to approximate the original structure of the fractured bone. Fully eventually occurs in the healing process for the regeneration of nerve endings.
Tissue remodeling as a mirror image of the load
On the small load the body often reacts hyperadaptací - compensation greater than the force inducing stimulus. This principle theoretical medicine , which is the essence of hardening, applies more generally. For example, low doses of radiation induce a stress response which has adaptogenic effect ( Joiner1999ari ). In other words, the individual is occasionally exposed to moderate radiation suffer mutations less than completely radiation-free environment ( Jonezavův effect ). For physical activity is similar to that: Although physical exertion increases the immediate wear, intermittent exercise leads to better health (ie. Less overall wear) than physical stress completely zero. Hyperadaptací is tan - darkening of the skin after exposure to UV radiation.
Principle hyperadaptace is ubiquitous in physiology - providing adaptive modeling tissue only during wound healing, but also in general during ontogeny (i.e. normal growth and maturation). Even in adulthood, after the end of the growth phase, subject to constant remodeling of tissue on the principle hyperadaptace: muscle and collagen fibers, which is under load break, they are repaired and reinforced. Those that do not harm never ever (do not carry the load) over time are eliminated as unnecessary. Everyone who was in the cast knows how the muscles are weak after the forced inactivity. Happiness muscle fiber innervation is also essential - without it, muscles atrophy, as we observed in paralyzed. Remarkable structure beams of long bones that inspired Gustava Eiffela to construct the tower, there is a more or less self - bone is remodeled under load so that the load carried with a minimal amount of bone material. Physical exercise and mild mechanical load can therefore sort the adaptogenic effects.
Blood supply in wound healing
Injuries usually accompanied by more or less bleeding, tissue loss due to damage to blood vessels. Therefore inseparably healing includes regeneration of vasculature. Due to ischemia may succumb to the wounded area necrosis (necrosis). Damaged tissue to survive and be healed, it is necessary to restore the blood supply. For this reason, Hirudo medicinalis (Hirudo medicinalis), an expert blood supply, on account of many miraculously cured a patient with přišívanými fingers. (That's capability is probably the reason for the effectiveness of leeches for ischemic heart disease and heart attack . As a biologist, I wonder if there are red streaks leeches medical badge as the shrimp striped, or has just happened. Other inhumane healer, see article Martine Balzarová . In turn I apologize.) the healing process is also important regeneration of blood vessels - ingrowth of newly formed capillaries in a healing place. Drugs have a positive effect on the regeneration of blood vessels have a good chance that it will also accelerate wound healing and recovery.
Regeneration as a decisive factor in health and disease
Each tissue at each time was subject to influences ranivým (mechanical stress, chemical injury, radiation damage, ...) and healing (natural tissue regeneration). In healthy people normally have healing effects far outweigh ranivými. Greater injury (injury) is a sudden, one-time event, and healing is a natural process of returning to health. For people suffering from chronic diseases but it could be otherwise. The tissue affected by chronic illness is permanently exposed to injurious influence and if this outweighs the regeneration resulting non-healing wounds. For example, chronic diseases of civilization such as diabetes or varicose veins ( varicose veins , hemorrhoids , varicose veins of the esophagus ) can cause ischemia of the skin and creating a leg ulcer that does not heal simply because of insufficient blood supply to allow recovery of the affected area. Even slight acceleration of healing processes, for example by improving blood supply can lead to cure chronic disease.
Healing and regenerating effects of herbal adaptogens
Adaptogens generally tend to have regenerative effects. Traditionally used to improve the appearance of the skin to heal some types of skin inflammations and also for more serious injuries and postoperative conditions. In the 20th and especially in the 21st century in many herbal adaptogens confirmed experimentally regenerative effect in mammals. For model adaptogen ginseng was found positive effect for burns and skin injuries. Adaptogens effect in wound healing can be partly explained by a regenerative effect on blood vessels (capillaries grow etc.)
Ancient TCM textbooks describe the use ginseng to treat certain skin inflammations (atopic dermatitis etc.) at skin injuries and also at larger accidents. By studying literature, I concluded that this effect is real and not just an artifact tendency to unpublished negative results (as is the case in my opinion, for example in studies describing the direct anticancer effect of ginseng ). The positive effect of ginseng on the healing of wounds is now most commonly used for postoperative conditions. Most studies in this area comes from the last few years:
- According to a Japanese study Kimura2012egr (mouse) is ginsenoside Rb 1 in the most efficient healing of burns majority of the studied ginseng panaxosidů (Rb 1, Rb 2, Rc, Rd and Rg 1), primarily due to improved vascular regeneration. According to the same study, ginsenoside Rb 1 at very low doses to protect the skin from UV damage.
- Ginseng ( Kimura2006egs ) and specifically ginsenoside Rb 1 ( Kawahira2008egr ) improves the healing of burns (mouse).
- Ginsenoside Rb 2 improved the healing of damaged skin ( Choi2002epe ).
- When test 40% liver resection in dogs ginseng increased regeneration rate of 20% ( kwon2003ekr ).
- Ginseng operates in curative trials for atopic dermatitis ( Lee2011ekr , Kim2011eta , Sohn2011ekr , Lee2011krg , Cho2013ekr ).
Other adaptogens and medicinal plants with healing effects
Ginseng is an adaptogen significant healing and we could talk about it more, but there are other effective adaptogens and medicinal plants. A German study Wang2013wpf studied TCM herbs effect on survival and division of human keratinocytes. There was most effective Paeonia suffruticosa (Paeonia suffruticosa), was moderately potent ginseng notoginseng , Wild Angelica Chinese and Japanese honeysuckle (Lonicera japonica). According Chen2013ain astragalosid IV Astragalus blanitého had a positive impact on wound healing and scarring limitations. The positive effect of the antioxidant curcumin on wound healing summarizes ( Tejada2016whe ). TCM has its own combination of these and other plants traditionally prescribed for injuries. Among other healing adaptogens are lies vrcholák tannic (Terminalia chebula, Bag2013dtc ) Lithospermum officinale (Lithospermum officinale) and also various plants lesser-known traditional cultures. Effective are our traditional medicinal plants: blackberry, free, dogwood, comfrey and many others, even ordinary cabbage ( Rebolla2013ebo ) ..
And a protective effect on the vascular endothelial (tens of works, e.g. Li2008ibc ) is the essence of the protective effect of ginseng in heart disease . Ginseng but also improves the recovery (growth) after vascular injury and this is the basis of much of its efficacy in wound healing. It is also possible that ginseng positively affects the construction and remodeling of connective tissues. They appear because both articles documenting the use of ginseng against scarring ( Pazyar2012gpn , Yao2007epn ), sophomore articles warning, alerting physicians to patients forbid earth ginseng ( Pribitkin2001htw ), that the same situation as the well-proven cardiac effects of ginseng. Overview of several representative studies here:
- The ginseng saponin in an experimental model accelerates the growth of capillaries ( morisaki1995mae ).
- Ginsenoside Rg 3 capillaries improves regeneration effect on PPAR-gamma receptors ( Kwok2012sg2 ).
- The mechanism of angiogenic effect of ginsenoside Rg1 analyzes Cheung2011gia .
- Ginsenoside Re enhances angiogenesis and positive effect on the cardio-vascular system ( Peng2012grp ).
- Total ginseng extract has a positive effect on angiogenesis factors in the context of myocardial infarction ( Ahn2011rge ).
- Improving angiogenesis ginseng mention key reports as chen2008cpe .
Besides panaxosidů which accelerates the growth of vessels and there are those that have a capillary rise effect inhbiční (e.g. ginsenoside Rg 1 versus Rb 1 ). This is not a contradiction content of substances with conflicting influences is frequent among adaptogens topic and regeneration of blood vessels it, scientists are well aware ( Sengupta2004may , Leung2007gri ).
Other adaptogens and medicinal plants with angiogenic effects
Proangiogenic effect also have other species of the genus Panax, for example, P. notoginseng, the total saponin in a concentration of 0.1μg / ml accelerates division of endothelial cells, increases the level of vascular growth factors and promotes the growth of capillaries ( Hong2009aes ). Plants have a positive effect on the regeneration of capillaries will certainly be a lot more, and I'm not under any illusions that I had a chance to mention them all here. I found at least a few: According Panossian2008psc 's Schisandra Chinese , according Majewska2011pap also milkvetch membranous , Wild Angelica Chinese , sea buckthorn (Hippophae rhamnoides), and in addition also aloe vera , whose positive effects on wound healing summarizes Hashemi2015rpa .