Transcript FISIOLOGI PENYEMBUHAN LUKA woc c e l i n i c a P ro fe ssio n a l N u rse L e a d.
Slide 1
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 2
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 3
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 4
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 5
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 6
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 7
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 8
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 9
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 10
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 11
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 12
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 13
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 14
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 15
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 2
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 3
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 4
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 5
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 6
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 7
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 8
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 9
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 10
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 11
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 12
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 13
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 14
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA
Slide 15
FISIOLOGI PENYEMBUHAN
LUKA
woc
c
e
l i n i c
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.
THE FATHER OF MOIST
WOUND HEALING
Home WORK : Why MOIST ?
JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel
2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab
3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )
4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh
makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.
5. Pembentukan growth factor : lebih cepat pada suasana lembab
* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1.
Healing by First Intention
2.
Healing by Second
Intention
3.
Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
Tanda : kemerahan, panas,
nyeri dan bengkak
Last approximately 4 to 5
days
Permulaan terjadinya proses
penyembuhan luka :
aktifitas platelet untuk
STOP perdarahan dan
triggers the immune
response
24 jam pertama saat terjadi
perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
bakteri dan membuang
jaringan mati (
mempersiapkan dasar luka )
Characteristic red color and
warmth is caused by the
capillary blood system
increasing circulation &
laying foundation for
epithelial growth
PROLIFERATION STAGE
Begins within 24 hours of
the initial injury and may
continue for up to 21 days
Formation of new capillaries
that generate and feed new
tissue
It is characterized by three
events:
Granulation tissue is the
beefy red tissue that bleeds
easily
Epithelialization
Granulation
Collagen synthesis
PROLIFERATION : EPITHELIAZATION
Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
It is essential to have a
moist environment to foster
growth of this layer
It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
Creates a support matrix for
the new tissue that provides
it with its’ strength
Oxygen, iron, vitamin C,
zinc, magnesium & protein
are vital for collagen
synthesis
This stage is the actual
rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
FINAL stage of wound
healing
Begins around day 21 and
may continue for up to 2
years
Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA