During an acute inflammatory reaction, monocytes and lymphocytes migrate to the wound site where polymorphonuclear leukocytes (PMNs) and monocytes/macrophages are present in highest concentrations. PMNs have short lifespans of hours to days while macrophages can last days to weeks, eventually becoming the predominant cell type in a chronic inflammatory response. Monocytes rapidly differentiate into macrophages, which are principally responsible for normal wound healing and the foreign body reaction. A foreign body reaction involving granulation tissue development, macrophages, fibroblasts and capillaries is differentiated from chronic inflammation. Persistent inflammation leads to chronic inflammation, while the localized response to biocompatible materials is considered a surface reaction or foreign body reaction involving normal wound healing.
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During the acute inflammatory reaction
1. During the acute inflammatory reaction, monocytes and lymphocytes migrate into the wound
site.The simplistic view of an acute infammatory responde followed by a chronic inflammatory
response may be arroneous in regard to biocompatibility studies and the infammatoy response to
implats.Studies that cause the cage implant system show that monocytes/macrophages are
present in highest concentrations when PMNs are also at their highest concentrations, i.e., the
acute inflammatory response. PMNs have short lifetimes (hours to days) and disappear from the
exudate more rapidly than macrophages with lifetimes of days to weeks. Eventually macrophages
become the pedominant cell type in the exudate, resulting in a chronic inflamatory response.
Monocytes rapidly differentiate into macrhophages, the cells principally responsible for normal
wound healing and the foreign body reaction. Clasically, the development of granulation tissue is
considered to be a part of chronic inflammation, but because of unique tissue-material
interactions, we prefer to diferentiate foreign body reaction with its varying degree of granulation
tissue development including macrophages, fibroblasts, and capillary formation from chronic
inflammation.
Persisten inflammatory stimuli lead to chronic inflammation. While this is generally the situation
with implanted artificial organs, medical devices, and biomaterials, the response to biocompatible
materials is localizated and considered to be a surface reaction or response.The term chronic
inflammation with the presence of mononuclear cells, including lymphocytes and plasma cells, is
given tha designation chronic inflammation, while the foreign body reaction with granulation
tissue development may be considered to be the normal wound healing response to inert
biocompatible the normal wound healing response to inert biocompatible materials, i.e., the
normal foreign body reaction.