Injury healing and tissue repair- Part 2

In Part 1 we looked at the role of inflammation in wound repair and the management of inflammation. Part 2 is about tissue perfusion. A lot of this information is applicable for preventing tissue damage in the first place and explores practises that ensure better recovery. Injuries, wounds etc obviously come in many different forms, so this information is general only.

What are tissues? Tissues are groups of cells that are bound together or are working together as a team to do a special job. You could think of cells as being the bricks in the house, and tissues as being the walls i.e. the bricks/cells combine together to form the walls/tissues. Just as cells combine to create tissues, tissues combine to create organs. Using our house building analogy, an organ would be a group of walls working together to become a room! And all of our organs working together as a team are the equivalent of the house as a whole.

Good tissue perfusion is a good blood supply to the tissues. Good tissue perfusion is really helpful when it comes to repairing wounds and/or reducing excess inflammation. When enough blood is being delivered to our body tissues, the cells in our tissues are being nourished with nutrients and oxygen from our blood. As well as delivering what the cells need to survive and thrive, our blood also helps to remove waste products from the tissues and cells, which is just as important for maintaining healthy tissue and cellular function.

One of the first things I think about when it comes to good tissue perfusion, is the quantity and quality of the capillaries branching out through tissue beds. Capillaries are our smallest blood vessels, which means they can squeeze into tiny spaces, spreading out to fill up more space like the twigs on a tree (in this analogy, larger blood vessels are like the branches of the tree, and the heart itself is the trunk!)

If there are more capillaries, there is better oxygen and nutrient supply, and better waste removal (and hence better healing!) The capillaries also need to be tough, but flexible, in order to do their job properly. So what helps improve the quantity and quality of our capillaries, and what damages them?

First up, exercise! Good common sense says caution should be used if you are dealing with an open wound, as movement may pump extra blood out through the wound and tear stitches, but regular exercise can ensure good recovery from injuries, wounds and tissue damage.

Not only does exercise pump top quality oxygen through our tissues, helping our entire body (cells included) to ‘breathe’ properly, exercise increases the number of capillaries in our tissues, which means more oxygen and nutrients are being delivered and waste products are being more effectively removed.

Exercise also strengthens the walls of the capillaries. When more blood is being pumped through our capillaries during exercise, the walls are being stretched or ‘exercised’. This makes them stronger, more flexible, and more resilient! On a side-note, a very similar thing happens to the bowel when we exercise its walls with natural fibre from whole foods. Without fibre, there is no bulk, and the bowel wall can lose strength and tone.

Another very important choice we can make to strengthen our capillaries is a good diet. When I think of healthy capillaries, I think of ingredients in plants like vitamin C and flavonoids.

Vitamin C (ascorbic acid) makes capillaries stronger. Green leaves, fresh fruits and vegetables all contain useful levels of vitamin C. One of the richest (and a favourite of mine) are rose hips. Why not just take a vitamin c supplement? Because on its own (without the synergistic nutrients that usually accompany it in whole foods) ascorbic acid isn’t as effective, and may have a pro-oxidant (i.e. ageing) effect on our cells and tissues. Synergistic nutrients are nutrients that are often found together in nature and they work together as a team in very magical ways. For example, they can combine to create healing actions that neither might have on their own, or one can make the therapeutic action of the other much more potent.

Some of the important synergistic nutrients found alongside vitamin C in nature are the flavonoids. Anthocyanidins are flavonoids with venotonic properties, which means they make our veins stronger. Our veins are blood vessels that remove wastes from our tissues. Anthocyanidins are present to some extent in all green leaves, and help to create the blue, red and purple pigments in many flowers and fruits. Some good sources of anthocyanidins include blueberries, blackberries, currants, raspberry, red cabbage, eggplant and purple potatoes. One of my favourite herbal sources is bilberry.

Flavanones (also known as bioflavonoids or vitamin P) are a group of flavonoids that tone blood vessels, and they are rich in all the same foods vitamin C is found in, such as broccoli, cabbage, kale, parsley, capsicum, black currants, guava, kiwifruit, mango, orange, pineapple, rockmelon, and strawberry. Another group of flavonoids that strengthen and protect blood vessels are the flavonols, like quercetin and rutin. Quercetin is found in gingko biloba, and one of my  favourite herbs for the cardiovascular system, hawthorn. Rutin is found in citrus and herbs such as horse chestnut.

Aside from improving the quantity of capillaries running through our tissues and making sure the capillary walls are strong and supple, another thing to think about is how open or narrow the space inside the blood vessels might be. In herbal medicine we have herbs that can help narrow the blood vessels (vasoconstrictors) and herbs that widen the blood vessels (vasodilators). The constrictors can be helpful when we want to stop bleeding, while the vasodilators lower blood pressure and bring more blood into our tissues. Some helpful vasodilators include astragalus, watermelon, celery, gingko, garlic, beetroot, spinach, hawthorn, gotu kola, lime blossom, yarrow and mistletoe.

Another group of herbs I think about when there is tissue damage are the herbs that improve the way our lymphatic vessels work. Lymphatic vessels are similar to blood vessels but instead of carrying blood, they carry fluid out of our tissues. This prevents swelling (fluid retention) but it also ensures wastes from the cells and tissues are removed. Helpful lymphatic foods and herbs include most of the foods already mentioned, along with herbs like echinacea. As with our blood vessels, our lymph vessels are kept healthy with physical exercise.

So what hinders oxygen and nutrient supply to tissues, and waste removal? Inactivity can result in less robust and extensive blood and lymph support for our tissues. And when it comes to diet, a lack of whole plant foods will starve our cardiovascular system of the nutrients it needs to stay healthy. Our blood vessels can be damaged by excess refined salt, refined sugar, refined oils, animal products (i.e. animal flesh, breastmilk or eggs), junk foods, processed foods, smoking, and deep-fried foods. Chronic inflammation (as discussed in part 1) can also damage blood vessels.

Lastly, consider mental and emotional health: if we aren’t in a good space mentally and emotionally and we aren’t able to cope with with stresses in our lives, we won’t look after ourselves well with exercise and diet. Stress (e.g. intense emotions, negative thought patterns) can also have a damaging effect on our blood vessels and impair our ability to digest nutrients from our foods that support and nourish our tissues. So as well as exercising and eating a whole plant foods based diet, we need to get enough sleep and cultivate better mental and emotional health in order to reduce the negative impact of stress on our body tissues!

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