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Danya Al-Abdullatif Ms. Arwa Hassan Eng 312 16.05.11 Phases of Wound Healing The process of wound healing is a very interesting and complex procedure. It begins the moment an injury occurs and continues for months and sometimes years depending on the type of wound. There are three different phases of wound healing: inflammatory, proliferative, and remodeling. So, in order to fully comprehend this process, we must take into account the different steps involved in each phase.

The immediate onset of an injury is known as the inflammatory phase. When the injury causes bleeding there immediately follows a narrowing of the blood vessels. This process, called vasoconstriction , is the body's natural blood saving system. The process works by stopping a person from hemorrhaging and preventing severe blood loss by restricting overall blood flow in a time of need, such as while sustaining an injury. As this process is happening, another one, known as hemostasis, is going on. Hemostasis is when a clot forms and various chemical substances are released into the wound that will begin the healing process.Among the most important of these chemical substances is platelet aggregation, a crucial step in the process of clot formation to stop bleeding. The aggregation of platelets results in the formation of thromboplastin that aides in forming the clot. Thus, through the interaction of various coagulation processes and platelet membranes,the plug sticks, clumps, and becomes solid. While this is happening to the wound, tissue inflammation occurs in

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response to the injury in order to help in wound healing and eliminate pathogens. At the same time, vasodilation occurs when hormones stimulate the heart to beat more rapidly and with more force in order to cause the dilation of some arterioles in areas of the body needing an increased supply of blood to keep the tissues alive and functioning properly. Over the course of several days, specialized immune system cells perform phagocytosis, which is a process that traps harmful materials when they enter the body and destroys them so that they cannot cause damage.

After the inflammatory phase, comes what is referred to as the proliferative phase in which a matrix or latticework of cells forms. During this stage, a process called granulation is collagen-rich tissue which forms at the site of an injury. As the body heals, this tissue fills in the injury, and may eventually scar over. The appearance of granulation tissue is a good sign because when a wound starts granulating, it means that the body is starting to rebuild after the injury. On this matrix, new skin cells and blood vessels form and it is the new small blood vessels (known as capillaries) that give a healing wound its pink or purple-red appearance. These new blood vessels supply the rebuilding cells with oxygen and nutrients to sustain the growth of the new cells and support the production of more collagen. This collagen acts as the framework upon which the new tissues build. In the contraction phase, collagen is the dominant substance in the final scar which facilitates in helping wound edges pull together to reduce defect . In epilialization, a process that begins within a few hours of the injury and is complete within 24-48 hours, there is a laying down of new skin or epithelial cells. Cells travel about 3 cm from the point of origin in all directions so as to form a protective barrier between the outer environment and

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the body. The primary purpose of this barrier is to protect against excessive water loss and bacteria.

Beginning 2-3 weeks after the onset of injury is the final phase in wound healing, known as the remodeling phase. Depending on the severity of the wound this phase can last from 3 weeks to 2 years in which time the collagen framework becomes more organized making the tissue stronger. The blood vessel density becomes less and the wound begins to lose its pinkish color. Although the area increases in strength, scar tissue is only 80 percent as strong as original tissue.

Therefore, the complex phases involved in wound healing are a testament to the body's tremendous ability to heal itself. All three stages involved in the recovery processinflammatory, proliferative, and remodelingare vital and necessary for rebuilding the site of injury.