Wound healing is a continuous process which begins at the time of injury.<\/p>\n
The\u00a0process of normal healing can be divided into three phases: inflammation, repair, and\u00a0maturation.<\/p>\n
a. Inflammation<\/strong>. The process of inflammation begins within minutes following a\u00a0laceration. An increased blood supply with edema and engorgement of surrounding\u00a0vessels accounts for the inflammatory appearance.<\/p>\n b. Repair<\/strong>. A healthy patient with optimal wound care can expect a semblance\u00a0of order in the wound to appear on the third day. The cellular and chemical activity\u00a0during this phase results in “granulation tissue.” Although signs of inflammation subside\u00a0successively during this phase, the wound remains red, raised, and often itchy.<\/p>\n c. Maturation<\/strong>. During this phase of wound healing, there is a progressive\u00a0decrease in the vascularity of the scar and an increase in the strength of the scar.\u00a0Maturation of a scar can occur up to two years after the injury took place. Ideal scarring\u00a0occurs in three stages.<\/p>\n (1) Stage I–0 to 4 weeks; the scar is soft, fine, and weak.<\/p>\n (2) Stage II–4 to 12 weeks; the scar is red, hard, thick, and strong.<\/p>\n (3) Stage III–12 to 40 weeks; the scar is soft, supple, white, and loose.<\/p>\n d. Complications<\/strong>. Wound complication refers to anything abnormal in the\u00a0healing process. The term also refers to the loss of function of a body organ, the\u00a0function loss caused by the initial wound. Infection is the single most common wound\u00a0complication. Other complications of wound healing include bleeding, dying tissue, and\u00a0improper healing.<\/p>\n (1) Continued bleeding. Bleeding must be stopped to allow the healing\u00a0process to proceed.<\/p>\n (2) Dying tissue. Tissues at the site of severe injuries may have been\u00a0severely damaged by being deprived of their blood supply with its oxygen and nutrients.\u00a0These tissues will die and must be removed or carried away in the capillaries for healing\u00a0to take place properly.<\/p>\n (3) Results of improper healing. Here are a number of possible results of\u00a0wounds that have not healed properly.<\/p>\n (a) Keloid. A keloid is excessive scar tissue growth. Keloids occur\u00a0primarily in dark-skinned people. Given the proper conditions, anyone can develop a\u00a0keloid, however. It can be removed surgically for cosmetic reasons. A keloid is the\u00a0result of improper wound healing.<\/p>\n (b) Abscess. An abscess is a localized infection in which there is an\u00a0accumulation of pus. Pus is a liquid accumulation of phagocytes (also called\u00a0leukocytes). An infecting microorganism causes the abscess. The particular\u00a0microorganism involved determines whether the pus is white, yellow, pink, or green.<\/p>\n (c) Cellulitis. Cellulitis is an inflammation of the deep, subcutaneous\u00a0tissues and sometimes muscles, usually caused by infection of a wound or burn.\u00a0Cellulitis sometimes occurs when an abscess is forming. This condition is serious\u00a0because the infection can spread rapidly and extensively in the tissue spaces.<\/p>\n (d) Empyema. Empyema is the collection of pus in an already existing\u00a0cavity, such as in the gallbladder or the lung.<\/p>\n (e) Fistula. A fistula is an abnormal passage between two internal\u00a0organs. A wound that heals improperly could cause such a passage.<\/p>\n (4) Blood supply. Since blood supplies the products used in healing, any\u00a0factor that restricts blood circulation to a wound area interferes with healing. Dead or\u00a0edematous tissue, restrictive bandages, and damaged arteries can all slow the healing\u00a0process.<\/p>\n e. Physiological Responses to Wounds<\/strong>. Once the skin and tissue have been\u00a0injured, the process of healing begins. Many factors influence the body’s ability to grow\u00a0new tissue.<\/p>\n (1) Age. Very young and very old people heal more slowly than those in\u00a0other age groups. People in these age groups have less ability to fight infection, and\u00a0fighting infection is a major part of the healing process.<\/p>\n (2) Malnutrition. Malnourishment and obesity are both forms of malnutrition\u00a0that affect wound healing.<\/p>\n (a) A person who is undernourished has less fat and carbohydrate\u00a0reserve; therefore, body protein (necessary for wound healing) must be used to provide\u00a0energy needed for basic metabolic functions. This results in an imbalance of nitrogen\u00a0which in turn depresses fibroblastic synthesis of collagen, the connective tissue for scar\u00a0formation. A person suffering from Vitamin C deficiency may not be able to produce\u00a0fibroblast, causing a delay in wound healing.<\/p>\n (b) In obese individuals, fatty tissue may keep foreign matter from\u00a0being seen. Fatty tissue has relatively few blood vessels, causing such tissue to\u00a0separate easily. Tissue that separates easily heals slowly.<\/p>\n (3) Abnormalities in endocrine function. Healing is slow if there are such\u00a0abnormalities. In a person suffering from chronic vascular changes, the injured tissues\u00a0of the wound may not get enough blood to heal at a normal rate. Persons having\u00a0corticosteroid therapy will find that wounds heal more slowly.<\/p>\n (4) Hormone production and carbohydrate metabolism. The combined\u00a0effect of the increased hormone production is to increase the metabolism of\u00a0carbohydrates. The metabolism of carbohydrates is important in the body’s response to\u00a0trauma. If the body’s store of carbohydrates is depleted (severe crush injuries,\u00a0starvation), the body will begin to use fats and proteins in place of carbohydrates.\u00a0Eventually, there will not be enough carbohydrates to aid in the healing process.<\/p>\n","protected":false},"excerpt":{"rendered":" Wound healing is a continuous process which begins at the time of injury. The\u00a0process of normal healing can be divided into three phases: inflammation, repair, and\u00a0maturation. a. Inflammation. The process of inflammation begins within minutes following a\u00a0laceration. An increased blood supply with edema and engorgement of surrounding\u00a0vessels accounts for the inflammatory appearance. b. Repair. A … Continue reading 2-4. WOUND HEALING<\/span>