Reject
Reaction of Necrotic Tissues of Burns Wounds
At 72 h postburn, the wound tissue comes into a
phase of rejection
reaction, which is a response of the viable tissues due to
disintegration of necrotic tissue and cells in the interface of the
lesion area.
Usually mixed and extensive, this reaction process
primarily includes three
patho-geneses:
(1) the
disintegration of
necrotic histiocytes in the injury interface;
(2) the
regeneration of
viable histio-cytes in the interface of the lesion area;
(3) microbial
infection in the injury interface.
Besides an inflammatory reaction,
disintegration of necrotic histiocytes may induce cell liquefaction in
the injury interface and, more importantly, the accumulation of cell
liquefied products continues the aggravation of the injured
tissue.
Meanwhile, the residual viable tissues in the
injury
interface begin instinctive regeneration when disintegrated tissues
develop into a destructive substance unfavorable to the environment of
cell regeneration, thereby inducing serious inflammation.
The combination of the two above pathogeneses
disturbs
flora residing in the skin and causes the destruction of microbes in
the injured area, both of which further aggravate damage and may result
in systemic injury at any time.
This process is called ‘rejection injury of
necrot-ic tissues’, and is the last primary
injury of a burns wound.
|