The initial phase is the stopping of blood flow which involves both the constriction of blood vessels at the site of the wound as well as the formation of a clot. Blood cells called platelets are an integral part of a blood clot and they secrete a variety of growth factors and inflammatory mediators that initiate the process of tissue repair. The second phase, the inflammatory phase, is characterized by redness, swelling, warmth, and pain and is mediated by an increase in blood vessel permeability which allows white blood cells to migrate into the surrounding tissue to clear debris and bacteria. The proliferative phase follows and is defined by the formation of new blood vessels and connective tissue (especially collagen) and a process by which new skin and mucous membranes replace superficial cells damaged or lost in the wound. The last phase of wound healing is wound remodeling, where the new collagen fibers are reorganized to yield greater tensile strength. This remodeling process can continue for almost two years, although 70% strength is achieved after just four weeks. [13] What is bromelain? Bromelain is the name given to a family of proteolytic enzymes that are extracted from the stems and immature fruits of the pineapple plant. [14] Proteolytic enzymes break the long chainlike molecules of proteins into shorter fragments and eventually into their components, amino acids. This enzyme activity is evaluated by how the commercial preparation of bromelain breaks down a compound like gelatin – e.g. gelatin digesting units per gram (GDUs/g). Although the proteolytic activity is responsible for many of its beneficial effects, some of the favorable effects are associated with other components contained in bromelain that are not proteolytic. Bromelain is currently categorized as a dietary supplement, and generally recognized as safe by the U.S. Food and Drug Administration (FDA).
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