Wound Healing


Any breach in the integrity of live tissue can be classified as a wound. The skin, the body’s largest organ, plays a crucial role in shielding water-rich internal organs from the arid external environment. Preserving skin integrity and possessing a robust ability to heal wounds are essential prerequisites for maintaining overall health. Moreover, the process of wound healing can pose a substantial challenge and financial burden on healthcare systems. In 2014, estimates for Medicare costs related to acute and chronic wound treatments ranged from $28.1 billion to $96.8 billion, with surgical wounds incurring the highest expenses, followed by diabetic foot ulcers.

Wound management generally follows three broad approaches. These approaches encompass primary closure with suture material, allowing the wound to heal without surgical intervention (healing by secondary intention), and healing by tertiary intention, where wounds are surgically closed after a period of secondary healing.

The process of wound healing involves a meticulously orchestrated series of events divided into four fundamental phases: Hemostasis, inflammation, proliferation, and remodeling. Hemostasis initiates immediately after injury, involving vasoconstriction and the formation of a blood clot to mitigate bleeding. The subsequent inflammatory phase encompasses the recruitment of white blood cells, particularly neutrophils, to clear debris and combat potential infections.

Transitioning into the proliferative phase, angiogenesis facilitates the formation of new blood vessels, while fibroblasts produce collagen, creating granulation tissue to fill the wound gap. Simultaneously, epithelial cells at the wound edges proliferate and migrate, initiating the process of Epithelialization. The final phase, remodeling, extends over months to years, involving collagen reorganization, scar formation, and wound contraction. Collagen fibers realign to attain strength, excess granulation tissue diminishes, and the wound undergoes contraction, ultimately resulting in scar formation.

The success of wound healing is contingent on the intricate interplay of growth factors, cytokines, and cellular interactions, with various factors influencing the duration and efficacy of each phase. Understanding these phases is imperative for healthcare professionals, enabling them to tailor interventions for optimal wound care, considering factors such as wound size, depth, individual health, and potential complications.

Courtesy:Almadani YH, Vorstenbosch J, Davison PG, Murphy AM. Wound Healing: A Comprehensive Review. Semin Plast Surg. 2021;35(3):141-144. doi:10.1055/s-0041-1731791 (Healing, Inflammation, and Fibrosis: Wound Healing: A Comprehensive Review – PMC (nih.gov)

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