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CHAPTER 5
Tissue healing
Healing is a matter of time, but it is sometimes also a 5.1 Wound healing
matter of opportunity.
— Hippocrates You can check Figure 5.1 for a summary of the wound
healing process and some of the individual mechanisms
The most studied and reported effect of laser therapy that have been reported to be affected by LT. When the
(LT) is tissue healing; for almost every cell or tissue endothelium is damaged and its collagen exposed, the
type you can think of, you will find related literature. coagulation cascade begins. Every wound healing process
There are clinical studies, in vivo experiments, and also starts with an attempt by the body to stop the bleeding.
in vitro experiments involving the particular cells that Platelets adhere and aggregate to start with, and
play a significant role in healing and their molecular later the fibrin net holds the clot in place. When plate-
mediators. lets are activated, they open up their granules, releasing
The common script for healing involves some kind (among other substances) the first factors that will start
of inflammatory response that triggers mechanisms promoting cell multiplication and tissue growth. These
to repair the damage, resulting in tissue that ideally growth factors are not exclusively produced by plate-
resembles the original undamaged tissue as much as lets, not even platelet-derived growth factor, but they
possible. Depending on the tissue type, the degree of do release a necessary initial burst, which is the basis of
this resemblance is variable with regard to structure, platelet-rich plasma therapy, a modality that is becom-
strength, and functionality. What LT achieves in tissue ing very common.
healing is to speed up this process and improve the A thorough explanation of their effects is beyond our
final product, but it will not make cells do things they scope, but their names are quite explicit and there is
don’t usually do; it increases their efficacy by a process evidence that LT enhances the expression of the fol-
similar to turning up the power of an engine and at the lowing growth factors, their receptors and the second-
same time providing it with more fuel. ary pathways they activate:
Worth mentioning before María dives into the different tissue types and their individual responses to laser therapy,
is the idea of enhancement of a process. What we mean to emphasize are two distinct, but related ways of
measuring progress.
• For a given time, an increased level of healing vs. conventional therapy.
• Getting to a given level of healing in less time vs. conventional therapy.
I think you intuitively know the difference, but keep these in mind as you read the rest of this chapter (and book).
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