The process of tissue repair is a complex series of events that leads to the production of scar tissue. This scar tissue provides effective material to restore the strength and integrity of the damaged tissue. There are 3 main phases of tissue repair, the inflammatory phase, the proliferative phase and the remodeling phase.
During the inflammatory phase, US has a stimulating effect on various components of your blood based immune cells including mast cells, platelets, white cells with phagocytic roles and macrophages. For example, ultrasound applied to injured tissue induces the degranulation of your mast cells, causing the release of various inflammatory chemicals which serve to breakdown injured tissues. The benefit of this mode of action is not to ‘increase’ the inflammatory response, but rather to optimize this needed initial inflammation. The repair process can only progress to the next phase (proliferation) when the inflammatory phase is effectively completed.
During the proliferative phase (scar production) US also helps stimulate your fibroblasts, endothelial cells and myofibroblasts. These types of cells help build connective tissue and are essential in the production of scar formation. US apparently helps to optimize your normal proliferative phase, producing the required scar tissue in an optimal fashion. Low dose pulsed ultrasound increases protein synthesis, enhances production of fibrous tissue and collagen synthesis.
During the remodeling phase of repair, the generic scar tissue that is initially produced is altered such that it takes on the functional characteristics of the original tissue that it is replacing. This process is achieved by reorienting the collagen fibers in the developing scar and facilitating the change in collagen type, from what is known as Type III collagen to Type I collagen. The remodeling process can be fairly lengthy and can last for more than a year. This remodeling process is essential for proper wound healing.
Therapeutic ultrasound can influence the remodeling of the scar tissue by facilitating the change from Type III collagen to Type I collagen effectively increasing the tensile strength of the scar while at the same time improving the scar mobility and functional capacity.
In summary, the application of ultrasound during the inflammatory, proliferative and repair phases does not change the normal sequence of healing events. However, scientific research shows that therapeutic ultrasound helps to enhance the normal sequence of these healing events and thus increase the efficiency of the reparative processes. This is why if you have recently had liposuction or are planning to do liposuction treatment you must incorporate therapeutic ultrasound into your post-recovery regimen.