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What are the Phases/Stages of Wound Healing?

Nurse dressing the patient's wound

Our body is a complex system. The process of healing wounds shows how the different systems of our body, along with proper wound care products, work together to repair the damaged tissues and revitalize the body area. 


How Exactly Does Our Body Heal?

The stages of healing of the wound proceed in an organized way and follow the four process: hemostasis, inflammation, proliferation and maturation.

The four stages of healing are pretty linear, but the progress can be backward or forward, depending on the internal and external conditions of the patient. Let us look at the four stages of healing, one after the other.


1. Hemostasis

This is the first stage of the wound healing process. This stage usually lasts for two days. As soon as there is a wound in the body, the blood vessels in the affected area constrict. This reduces the flow of the blood, a process called vasoconstriction.

At the same time, the clotting factors are released at the affected site to coagulate with fibrin. This, in turn, results in a thrombus, commonly known as a blood clot. The clot acts as a seal between the broken blood vessels to prevent further loss of blood.


2. Inflammation

The second stage of the wound healing process. This involves the phagocytic cells releasing oxygen species that are reactive. They last for seven days in acute wounds and longer in the case of chronic wounds.

In this phase, some enzymes along with white blood cells enter the wound. They clear off the bacteria and debris, starving the wound. This prepares the area for the growth of new tissue. What can physically be seen are inflammation and redness at the wound site, pain and heat.


3. Proliferation

This third phase of the wound healing process focuses on filling and covering the wound. As inflammatory cells undergo apoptosis, a process to eliminate unwanted body cells that are damaged beyond repair, wound healing moves to this third phase.

The proliferation process can be differentiated by the formation of new tissue , the formation of blood vessels (called angiogenesis), the contraction of the wound, followed by the process of restoring the epidermis, medically known as epithelialization.

The new tissue looks pink or reddish in the presence of the inflammatory agents. Tissue regeneration depends on the production of collagen proteins by fibro-blasts.

This phase can last for four days, or three weeks, or more, depending on the wound.


4. Remodeling

The final phase may occur over months or years depending on the initial severity of the wound, where it is located and the methods of treatment. Here, the new tissue becomes stronger and more flexible.

The tensile strength and elasticity of the skin are built by the Collagen agents. The accumulation of these collagen agents in the granulation tissue results in the formation of scar tissue, which is 20% weaker and less elastic than pre-injury skin.

The stages of wound healing are a complex and fragile process. If any of the above stages fails to proceed, it could lead to chronic wounds.

The factors that lead to chronic wounds are venous disease, infection, diabetes, and metabolic deficiencies that hound the elderly. The stages of wound healing can be sped up by careful care, where the wounds are kept moist and clean, protected from re-injury and infection.

When we speak about proper wound care, let’s not forget that lifestyle factors also influence the healing process of a wound. Let’s take a look at some of these factors:

a. Nutrition

During the healing process, a balanced diet with adequate nutrient intake is extremely important. Foods that are high in vitamin A, B and C, zinc and copper help to speed up the healing.

b. Hygiene

It is very important for the care giver and the patient to maintain proper levels of hygiene. This avoids infecting the wound any further and enhances healing. Washing hands properly with soap or any agent. Using gloves and disposing them off later are ways to do this.

c. Age

Age plays a significant role in the healing of the wounds. With advancing age, the dermal layer of the skin thins down and elasticity decreases, increasing the amount of time taken for the wound to heal. Unfortunately, this is not a factor that can be improved or changed.

d. Medication

Certain medications and treatments often affect the process of wound healing. Steroids interfere with epidermal regeneration and suppress inflammation. The destruction of cells yields a longer healing process.

e. Obesity

Patients who are overweight are likely to experience slower healing. Owing to fat storage, the patient is at risk of further skin breakdown, affecting the elasticity of the skin.

Final Takeaways

The body works in wondrous ways to heal and replace devitalized tissue when the right healing environment is established. For complete wound healing, cells require a constant supply of oxygen and other nutrients.

The patient’s lifestyle plays a major role in creating ideal conditions for cellular activity.


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