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Updated: May 8, 2025
In this process the coagulum only plays a passive rôle by forming a scaffolding on which the granulation tissue is built up. The ligature surrounding the vessel, and the elements of the clot, are ultimately absorbed.
On further consultation with the wife it was learned for the first time that the object of cream of tartar was to prevent too quick granulation, and that probably some other acid-like substance, such as vinegar or lemon juice, might do just as well. So a small amount of vinegar was used instead, and reasonably good candy was produced.
Healing by second intention is characterized by pus formation and granulation tissue. After the first day, the surface of the wound may be more or less covered by red, granular-like tissue. Later this granular appearance is modified by an accumulation of creamy pus and swelling of the part, and finally scab formation and contraction of the new scar tissue.
The granulation tissue which forms as a result of the reaction of the tissues to the presence of the virus is chiefly composed of lymphocytes and plasma cells, along with an abundant new formation of capillary blood vessels. Giant cells are not uncommon, but the endothelioid cells, which are so marked a feature of tuberculous granulation tissue, are practically absent.
In course of time the epithelium thickens, and as the granulation tissue is slowly replaced by young cicatricial tissue, which has a peculiar tendency to contract and so to obliterate the blood vessels in it, the scar that is left becomes smooth, pale, and depressed.
Finally, the sequestrum lies loose in a cavity lined by tuberculous granulation tissue, and is readily identified in a radiogram. This type of sclerosis preceding death of the bone is highly characteristic of tuberculosis. [Illustration: FIG.
This is pulverized or granulated, the degree of granulation depending upon the size of the furnace. Coarse granulated carbon works better than finely pulverized carbon, and gives more even results.
Beyond this phagocytic action, they do not appear to play any direct part in the reparative process. These young capillary loops, with their supporting cells and fluids, constitute granulation tissue, which is usually fully formed in from three to five days, after which it begins to be replaced by cicatricial or scar tissue. Formation of Cicatricial Tissue.
This is true not only of the circumscribed gumma, but of the condition known as gummatous infiltration or syphilitic cirrhosis, in which the granulation tissue is diffused throughout the connective-tissue framework of such organs as the tongue or liver. Both the gummatous lesions and the fibrosis of tertiary syphilis are directly excited by the spirochætes.
The raw surface is first covered by a layer of coagulated blood and fibrin. An extensive new formation of capillary loops and fibroblasts takes place towards the free surface, and goes on until the gap is filled by a fine velvet-like mass of granulation tissue.
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