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Healing

Wound healing is the body's natural response to injury, involving processes of regeneration and repair to restore skin integrity. The healing process occurs in four stages: hemostasis, inflammation, proliferation, and maturation, with different types of healing including primary, secondary, and tertiary intention. Various factors such as smoking, stress, and infection can affect the healing process.

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31 views27 pages

Healing

Wound healing is the body's natural response to injury, involving processes of regeneration and repair to restore skin integrity. The healing process occurs in four stages: hemostasis, inflammation, proliferation, and maturation, with different types of healing including primary, secondary, and tertiary intention. Various factors such as smoking, stress, and infection can affect the healing process.

Uploaded by

maryashah307
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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WOUND

HEALING
Dr. JOHN VESLIN M. S.,
ASSITANT PROFESSOR

DEPT OF GENERAL SURGERY


WOUND
Introduction
Wound is a breakdown in the continuity of
the skin, this breakdown may vary from
a small cut to a full thickness .
.
2
Accordin
. g ło skin
Integrity

Open Close
nd d
woun
d
WOUND
HEALING
Introducti
on
the skin is our first line of barrier .when the skin
surface gets impaired ,microorganisms gets a
porta1 to enter and cause infection .the body has
a natural course of healing that works by
inhibiting microorganism's growth and to restore
the structure and function of damaged tissues .
Definitio
n
It is a response produced by the body to
injury for
attempt to restore normal structure and
function .
Process of
healing
the process of healing involves 2 distinct
processes
A) regeneration
B) repair
R eg ener atio n : is when healing takes
place by proliferation of cells and usually
results in restoration of original tissues .

R e p a i r : it is healing outcome in which


tissues do
not return in their normal architecture and
function
.Repair typically results in the formation of
scar
tissue
STAGE/ PHASES OF
WOUND
HEALING
1.initial vascular response —
Heamostasis
Immediate after injury ,clotting cascade is
initiated which provides a temporary blood clot
made of fibrin to plug the site of injury .
Simultaneously vasoconstriction occur in the
site of
injury for 5 to 10 min .These temporary
responses
The temporary clot acts as a framework for
further healing such as migration of
leukocytes ,fibroblast keratinocytes ,and
endothelial cells . It also acts as a growth
factors .
After this brief vasoconstriction ,vasodilation
occurs which causes oedema and
hyperthermia and initiate the process of
inflammation
2.
Neutrophils migrate to the
Inflammation site of injury whin first 24
h o u rs a n d stay there for 2 to 5 days .they initiate the
process of phagocytosis and this process is continued
by macrophages later .

these cells debride the dead and necrotic


tissue and kill the bacteria .neutrophils
augmen the inflammatory response by
releasing many proinflammatory cytokines
and also attract other
Macrophages arrives nearly 3 days after
injury to the site and they also release
many growth factors ,chemoRines
,cytDkines , and
proliferation and promoteofcell
formation extracellular
matrix
(ECM)
3. Proliferation or granulation
This phase lasts from 4 -20 days .
during this phase ,collagen is synthesized
with migration of fibroblasts to the wound
site .

Collagen is a white protein that helps in


strengthening of wound .as the amount of
collagen
increases the wound become stronger and
risk of wound dehiscence decreases .
This process also includes the angiogenesis to provide
abundant blood supply to the damaged tissues.

The tissue gets a translucent r e d colour with the


increase in the capillary network .this tissue is known
as granulation tissue a n d it mainly comprises of
coMagen so that it is fragile and shiny arid tends to
bleed easily
4.Maturation
it is the last
phase { phase of wound healJng it begins
Remodeling
after the formation of granulation tissue .during
) phase collagen continues to be synthesized
this
and the granulation tissue eventuaily hardens
to white scar
ti sue .
car tissue is false skin and does not have nerve
or
The wound undergoes remodeling and it gets
contract
In certain
to form individuals
a stronger scar, primarily the dark skinned
individuals ,there is ari abnormal a m o u n t of collagen
aggregation ,which can result in formatiOn of
hypertrophic sc a r o r a keloid
Types of wound
healing
the types of healing is influenced by the
amount of
tissue loss

wound
healing

Primar Secondar
y y
intentio ntenlion
n
1.Primary intention ( first
intention healing )
healing happens when there is complete closure of
the tissue surface and there is negligible or no tissue
loss .
This is characterized by the formation of a minimal
granulation tissue and scarring .it is also known as
A closed incision is an example of wound
healing by
primary intensions.it may result in less evident
scar
Prim ay 'ințêntion . '

Clean Early Hairline


incision Suture Scar
2.Secondary
a widespread wound includes significant tissue loss ,
intention
where the edges are unable to get approximated and
requires secondary intention of healing .
Pressure ulcers are an appropriate example of
secondary intention wound healing .
Secondary intention healing differs from primary
intention healing in 3 ways :
1. the repair time is longer
2. the scarring is greater
. increased risk for infection .
3.Tertiary intention
wound that are left open for 3 to 5 days to allow
edema or infection to resolve or exudate to drain
and are then closed with sutures ,staples , or
adhesive skin closure heal by tertiary
intention .this is also known as delayed primary
intention

. ,.... „. .,.. ...


„„ „! .
c r . i' . . • 1Ii vwi•' '
,. 1. ›I i‹*i n .i'
Process of healing:
1. Regeneration
2. Repair
Stages of wound healing :
1. Hemostasis
2. Inflammation
3. Proliferation
4.Maturation
types of wound
healing :
1.Primary intention
2.Secondary intention
3.Tertiary intention
Factors affecting wound
healing
I. Smoking
2.Stress
3.Hypertension
4.Pressure
5.Trauma
6.Desiccati
on
7.Maceratio
n
8.Oedema
9.Infection
10.Excessive
bleeding

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