Surgery

Overview of the Wound Healing Process



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The mechanism of wound healing is both a complex and a delicate process which at times can be disrupted through various mechanisms. Knowing the process of wound healing will enable both the patient as well as the caregivers to treat the healing tissues with due attention.

In general, the healing process can be categorized into several stages. These stages will have their specific functionality and disruption at any level would mean poor healing as well as the possibility of giving rise to complications.

Following a disruption to the skin and the related structures, the first thing you will notice is the bleeding. Being the first thing that needs to be controlled, the bleeding would be halted through a process of clotting cascades and several factors will influence in this regard. Some of these factors would be:

* Platelet aggregation

* Clotting factor accumulation

* Vessel wall contraction…etc.

The phase is named as the ‘haemostatic phase’ and can last from several minutes to even days.

Inflammatory phase:

Being considered the initial phase of the wound healing process, the inflammatory phase will see a rush of inflammatory mediator cells as well as tissue factors towards the wound site along with increased blood flow towards the region. At the same time, the local inflammatory process will try and eliminate the unhealthy tissues, bacteria, debris as well as other substances which will disrupt the healing process.

Proliferative phase:

In this process, the cells which arrive at the wound site will start to proliferate and secrete certain elements that will form the cellular matrix in the region. Fibroblasts are one such cell type which will proliferate and produce the collagen and other related substances in order to develop the new extra-cellular substance at the wound site.

At the same time, a re-vascularization process will also take place in order to provide the injured tissues and the newly formed tissues with adequate amounts of nutrition and energy.

The proliferating and growing cells of the region, more often the fibroblasts, will form the temporary tissue structure or layer which will be known as the ‘granulation tissues’ till such time it will be replaced by normal tissues of the region.

As the wound heals, the growing of the surface epithelium will also take place even though the deep would is not yet fully healed.

Among the cells that arrive to the region, the myoepithelial cells will support the wound to contract and oppose the edges more freely but, excessive contraction might cause disfigurement and contractures in certain individuals.

Maturation and re-modeling:

In this phase, the new tissues which were formed will strengthen as well as be molded in a way that it will exert the same functions as the previous tissue structures. Thus, the new cells will become aligned according to the stressors, as well as any excessive tissue generation which will usually be removed at this phase.

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