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Granulation tissue is composed of tissue matrix supporting a variety of cell types, [3] most of which can be associated with one of the following functions: formation of extracellular matrix; operation of the immune system; vascularisation; An excess of granulation tissue (caro luxurians) is informally referred to as "proud flesh". [4]
Keloid, also known as keloid disorder and keloidal scar, [1] is the formation of a type of scar which, ... It is a result of an overgrowth of granulation tissue ...
Granulation results in a broader scar. Healing process can be slow due to presence of drainage from infection. Wound care must be performed daily to encourage wound debris removal to allow for granulation tissue formation. Using antibiotics or antiseptics for the surgical wound healing by secondary intention is controversial. [104]
Scar tissue is composed of the same protein as the tissue that it replaces, but the fiber composition of the protein is different; instead of a random basketweave formation of the collagen fibers found in normal tissue, in fibrosis the collagen cross-links and forms a pronounced alignment in a single direction. [1]
As granulation tissue matures, the fibroblasts produce less collagen and become more spindly in appearance. They begin to produce the much stronger type I collagen. Some of the fibroblasts mature into myofibroblasts which contain the same type of actin found in smooth muscle , which enables them to contract and reduce the size of the wound.
Fibrosis, also known as fibrotic scarring, is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of permanent scar tissue. [1] [2]
Age, bone type, drug therapy and pre-existing bone pathology are factors that affect healing. The role of bone healing is to produce new bone without a scar as seen in other tissues which would be a structural weakness or deformity. [2] The process of the entire regeneration of the bone can depend on the angle of dislocation or fracture.
When healing by secondary intention, granulation tissue grows in from the wound edges slowly over time to restore integrity of the skin. Healing by secondary intention can take up to months, requires daily wound care, and leaves an unfavorable scar, thus primary closure is always preferred when possible.