Wound Healing
ANSWERS
The dynamic process of wound healing is an excellent illustration of how our body’s various systems and the appropriate wound care products work together to repair and replace devitalized tissues. The body is a complicated and remarkable machine. But precisely, how does our body recover?
To repair the damaged tissues, our body automatically sets into motion a sequence of actions known as the “cascade of healing” when the skin is harmed. Hemostasis, Inflammatory, Proliferative, and Maturation are the overlapping stages of the healing cascade.
Hemostasis is the first phase.
The goal of hemostasis, the first stage of healing, which starts as soon as an injury occurs, is to halt the bleeding. The body begins to clot blood, activate its emergency repair mechanism, and creates a dam to stop drainage during this stage. Platelets interact with collagen during this process, which causes activation and aggregation. The center contains an enzyme called thrombin, which starts the development of a fibrin mesh and fortifies the platelet aggregates into a stable clot.
Phase 2: the Inflammatory/Defensive Phase
Phase 1 is mainly concerned with coagulation, while Phase 2, also known as the Defensive/Inflammatory Phase, is primarily concerned with eliminating bacteria and clearing away debris, effectively preparing the wound bed for the development of new tissue.
Neutrophils, a kind of white blood cells, enter the wound during Phase 2 to eliminate bacteria and clear away debris. After damage, these cells frequently achieve their peak population between 24 and 48 hours later, with a sharp decline in population after three days. Specialized cells called macrophages enter to continue removing debris as the white blood cells go. Additionally, these cells produce proteins and growth factors that entice immune system cells to the wound to aid in tissue regeneration. This phase typically lasts between four and six days and is characterized by edema, erythema (skin redness), heat, and pain.
Proliferative Phase, Phase 3
The goal of Phase 3’s Proliferative Phase, which follows the cleaning phase, is to fill and cover the wound.
There are three separate steps in the proliferative phase: 1) filling the wound, 2) contracting the wound edges, and 3) covering the wound (epithelialization).
The wound bed is filled with connective tissue, and new blood vessels are created during the first stage, characterized by glossy, deep red granulation tissue. The wound margins shrink and pull toward the center of the wound as it contracts. The third stage sees the emergence of epithelial cells from the wound bed or margins and their subsequent leapfrog migration across the wound bed to cover the wound in the epithelium. Typically, the proliferative period lasts four to 24 days.
Maturation Phase, Phase 4,
The new tissue gradually increases in strength and flexibility during the maturation phase. The tissue remodels and matures, collagen fibers restructure, and total tensile strength increases (albeit maximum strength is only 80% of pre-injury strength). The Maturation period can span anywhere from 21 days to two years and varies widely from a wound to wound.
The extraordinary and intricate healing process can be interrupted by local and systemic variables, such as moisture, infection, maceration (regional), age, nutritional state, and body type (systemic). The body heals and replaces devitalized tissue uniquely when the proper healing environment is created.
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