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platelet activation to attract the inflammatory cells. This phase occurs within minutes of the trauma being formed.
2 – Inflammation – Within hours inflammatory cells such as neutrophils, macrophages and lymphocytes debride damaged or injured tissues during this phase; Macrophages appear to be the most important cells in this phase since they phagocytose both the debris and bacteria. They also release substances which stimulate the next phase – proliferation. However, it has not been shown that tattoo ink particles are removed in this early stages of this phase. This phase can last for over three months (see figure 2).
3 – Proliferation – in this phase regrowth of tissues begins including epithelialisation, fibroplasia and the growth of new blood vessels etc. In addition, granulation tissue begins to form to contract the wounded areas with an increase in fibroblast cells leading to the synthesis and deposition of new collagen. This phase typically begins between 3 and 5 days post-trauma and invariably overlaps with the preceding inflammatory phase. However, the collagen synthesis process can continue at a rapid rate for approximately 2 to 4 weeks, after which the rate slows.
4 – Remodelling (or ‘Maturation’) – This phase mostly concerns the replacement of ‘old’ collagen with newly formed collagen. During this phase collagen becomes increasingly organized, with an increase in cross-linking of the fibres. This leads to a much stronger collagen matrix but can often result in scar tissue formation. This phase usually begins around 21 days after the original trauma, and can continue indefinitely! However, a healed wound will only ever reach around 80% of the original tensile strength of the original, unwounded skin!
It is likely that most of the removal of shattered ink particles occurs during this phase, when the ‘important’ stages above have been completed.
For a fuller account of these processes please
visit https://emedicine.medscape.com/article/884594-overview#a1.
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