Wound healing
Wound healing is a complex and intricate process where the body naturally restores integrity to damaged tissues. It is a well-coordinated sequence of events that include inflammation, proliferation, and remodeling, which can differ depending on the type of tissue involved and the extent of injury.
Phases of Wound Healing
Wound healing typically occurs in four overlapping phases: hemostasis, inflammation, proliferation, and maturation or remodeling.
Hemostasis: This is the first response to tissue injury, aiming to stop the bleeding through vasoconstriction, platelet aggregation, and clot formation.[1]
Inflammation: This phase aims to eliminate foreign substances, bacteria, and devitalized tissue from the wound. It is marked by the migration of white blood cells, particularly neutrophils and macrophages, into the wound site.[2]
Proliferation: This phase involves the formation of new tissue and is characterized by angiogenesis, collagen deposition, granulation tissue formation, epithelialization, and wound contraction.[3]
Maturation or Remodeling: The final phase of wound healing is the remodeling of the newly formed tissue, during which the wound contracts and the scar matures and strengthens.[4]
Factors Affecting Wound Healing
Numerous factors can influence the wound healing process, potentially causing either delayed healing or excessive scar formation. These include patient-related factors such as age, nutritional status, chronic diseases (like diabetes), and lifestyle habits (like smoking), as well as wound-related factors such as the size, location, and infection status of the wound.[5]
Clinical Implications and Management of Wound Healing
Understanding the principles of wound healing is essential for effective wound management. This includes wound cleansing, selection of appropriate wound dressing, and consideration of adjunctive therapies when needed. Certain wounds, such as chronic wounds, may require advanced therapeutic interventions including negative pressure wound therapy or growth factor administration.[6]
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- ↑ Landén, N. X., Transition from inflammation to proliferation: a critical step during wound healing, Cellular and Molecular Life Sciences, 2016, DOI: 10.1007/s00018-016-2248-0, PMID: 27147423,
- ↑ Eming, S. A., Inflammation in wound repair: molecular and cellular mechanisms, Journal of Investigative Dermatology, 2007, DOI: 10.1038/sj.jid.5700701, PMID: 17299434,
- ↑ Martin, P., Wound healing--aiming for perfect skin regeneration, Science, 1997, DOI: 10.1126/science.276.5309.75, PMID: 9096642,
- ↑ Wynn, T. A., Cellular and molecular mechanisms of fibrosis, Journal of Pathology, 2008, DOI: 10.1002/path.2277, PMID: 18161745,
- ↑ Guo, S., Factors affecting wound healing, Journal of Dental Research, 2010, DOI: 10.1177/0022034509359125, PMID: 20139336,
- ↑ Frykberg, R. G., Chronic wounds and diabetic foot, Diabetes/Metabolism Research and Reviews, 2009, DOI: 10.1002/dmrr.976, PMID: 19424953,
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