General process of wound healing
The principles of wound healing
The time a wound takes to heal can differ, andthere are many reasons for this. The reasons for this have been traced to age,patient lifestyle, pathology of the wound and if the patient has co-morbidities.
The healing process is broken down into 3 phases where each plays an essential role on the path to healing.
1 / The inflammation phase
Post injury, the body commences an impressive cellular response that begins a cleaning process that removes damaged or devitalised tissue. Some wounds have a yellow, brown or blackened tissue present, which we know as slough or necrosis, that requires a suitable plan for debridement.
2 / The granulation phase
This phase can be seen as the repair process and is the phase where fibroblasts, key cells in wound healing, proliferate. The wound will then take on a new appearance. Its red and shiny colouring is explained by the intensive production of collagen and the construction of new blood vessels. These will replace those that have been destroyed.
3 / The epithelialisation phase
Epithelial cells allow the wound edges to contract whilst robust healthy granulation tissue is present in the base of the wound until closure. The areas appearance will then be drier. Finally, new skin, initially pinkish and fragile, gradually forms,until it covers the entire wound which has become a scar. The latter will remain paler than the skin around it, until the melanin-laden cells responsible for the tone and structure come into play.
A moist environment to heal:
A moist environment for healing is nowadays well-accepted as advantageous for wound healing⁽¹⁾. It is proven to:
- facilitate the healing process by preventing dehydration, enhancing angiogenesis and collagen synthesis with increased breakdown of dead tissue and fibrin⁽²⁾
- improve the aesthetics of the wound, while decreasing pain⁽²⁾
- reduce the risk of infection, as compared to traditional dry therapies⁽²⁾
Did you know? Caring for your scar
It can take up to 12-18 months after a wound/surgery for a scar to settle fully. At the end of this long journey of reconstruction, the skin deserves some attention. Advise your patient to:
- Protect a scar from the sun (sun protection factor 50 is required)
- Moisturise the scar daily with a cream or an oil to help nourishing it
- Wear loose clothes around the scar to avoid friction which may irritate it
1. JunkerJP, Kamel RA, Caterson EJ, Eriksson E. Clinical Impact Upon Wound Healing and Inflammation in Moist, Wet, and Dry Environments. Adv Wound Care 2013;2(7):348–356. https://doi.org/10.1089/ wound.2012.0412
2. C.D. Hinman, H. Maibach, G.D. Winters Effect of air exposure and occlusion on experimental human skin wounds Nature, 200 (1963), pp. 377–378