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Wound Healing Stages

Wound healing starts immediately after an injury and ends when the structure is perfectly repaired.
Leena Palande
Last Updated: Sep 19, 2018
Wound healing is a dynamic process consisting of complex series of events. Damaged cellular structures and tissue layers are restored during different stages of wound healing. The process begins at the moment of injury and may continue for months to years. You should treat open wounds very carefully; as the wound may get infected, leading to complications.
Different Stages of Wound Healing
Wounds usually affect the outer most skin layer 'epidermis'. They can be experienced in hundreds of situations. Healing can be slow or fast, depending upon the cause and type of wounds, and upon physical fitness. For instance, elevated blood sugar levels can slow down healing process. Ordinary scrapes, burns, lacerations, punctures and cuts are mended fast.
Wounds are treated differently, depending upon the severity and type of wound. The healing process is divided into four wound healing stages.
Inflammatory Phase
The inflammatory phase begins with the injury itself. You must have noticed that the wound starts bleeding in the first phase. The blood vessels start narrowing right away. At the same time, small clots are formed at the site of the wound.
Certain chemical substances produced by the body are released right into the wound for the healing process to begin. Some special cells complete the task of clearing the debris from the wound.
Proliferative Phase
During the proliferative phase, formation of cell matrix can be observed. New skin cells and new blood vessels are formed on this extracellular matrix. Newly-formed blood vessels are responsible for the pink or red color of the wound. These newly-formed blood vessels provide nutrients and oxygen to the rebuilding cells. Thus, new cells grow.
This stage involves fibroplasia characterized by migration and proliferation of fibroblasts at the site of injury. They secrete a ground substance for extracellular matrix, release chemical factors that attract epithelial cells to the wound, and carry out collagen synthesis. Proteins, mainly collagen is essential to form a support for new tissue formation.
Epithelialization
Epithelialization involves the laying down of epithelial cells for the formation of new skin. It involves the migration of keratinocytes to the wound site. The epithelial cells that migrate to the site also phagocytose any debris and foreign material on their way. This stage begins within a few hours from the injury.
Remodeling Phase
By this time, collagen is better organized at the site and the tissues are strengthened by collagen. As the blood vessels become less dense, the wound loses its pink color. As the injured area becomes strong, the wound heals up to 70% of the original skin.
An open wound takes more time to heal as the inflammatory phase is extended. This generally leads to scarring. Scarring occurs only when the injury goes deep into the skin layers and reaches the dermis layer of the skin.
Deep cuts are required during surgery or deep wounds can be observed in cases of burns also. Healing stages of surgical wounds or deep wounds involve more wound care and may require intake of antibiotics too.
Small wounds are taken care of with first aid but deep wounds or surgical wounds require proper medication and care as they take more time to heal. Skin grafts may also be needed, depending upon the situation.
As deep wounds are closed with stitches or staples, wound care is important for avoiding infections or wound dehiscence. The internal stitches dissolve automatically but the external stitches are removed by the doctors. These days, dissolvable external stitches are usually used.
Age, bad diet, infection, hemorrhage, medical conditions like diabetes, anemia, etc. influence the wound healing stages. Dressing keeps the wound warm and promotes fast healing. You should consult your physician in case of pus, bleeding, increased pain or fever, as these can lead to complicated situations. Take care!