HEALING OF SKIN WOUND

Wound
A wound is a break in the
integrity of the skin or
tissues often which may be
associated with disruption of
the struction and function.
 HEALING
• Healing is the body
response to injury in an
attempt to restore normal
function.
• The process of healing
involve two distinct
processes:
vAbrasion
 ABRASION
• This is the mildest form of
skin injury characterized
by removal of superficial
part of epidermis. Since
the underlying basal
germinative layer of labile
cell is intract the
epithelium is restored with
no scarring
•
INCISION:
Incision and lectation involves the full
thickness of the skin but with minimal
loss of germinative cells. If the skin
edges are carefully opposed, as in
sutured surgical incision only a small
gap remains to be repaired. This
process, in which necrosis and
inflamation are minimal is known as
healing by first intention
 HEALING MECHANISM
q Healing by first intention
q Healing by secondary intention
Healing by first intension
Healing of wound with following characteristics:
vClean and uninfected
vsurgically incised
vwithout much loss of cells and tissue
vwounds with oppose edges
vprimary union
 STAGES
ØExudation of blood into the
space between the cut
ØFormulation of granulation
tissue
ØMature fibroblast laying
down collagen
ØMaturation of collegen and
devascularization forming
asascular scar
Healing by second intention
vWound with sepreated edges
vSecondry union
vWhen there is more extensuve
loss of cell and tissue
vAbundant granulation tissue grows
in form the margin to complete the
repair
 STAGES
ØCavity fill the blood and fibrin clot
ØCoagulum dries on its surface and forms scab
ØAcute inflamation starts at junction of living tissue
ØWound contraction leads to reducing its size
ØGranulation tissue forms in coagulm
ØScars forms from granulation tissue
 COMPLICATION OF WOUND HEALING
1. Infection: Most post-surgery
infections occurs within a
month causing redness,pain
fever and pus draining from
the wound. If you had device
implanted, it could take upto a
year for an infection to
develop.
2. Dehiscence:(brusting of
wound especially of abdomen)
3.Keloid: Accumulation of excess amount of
collegen that produce protruding tumorous
scar
4.Proud flesh: Formation of excessive amount
of granulation tissue which above the level of
the surrounding skin and blocks re-
epithelization.
5- Incisional hernia: Breakdown of deeper
layer of a wound in which the skin layer
remain intact with protrusion of underlaying
structures through the deeper defect
Factor Affecting Healing
Process
1. Systemic influences
2. local influences
 SYSTEMIC INFLUENCES
Factors that delay wound healing:
ØProtein deficiency: Protein are needed for process of
healing.Mathinonine is essential for building up of
granulation tissue.In protein deficiency granulation tissue
and collagen production is delayed,resulting in a weak
scar
ØVitamin C deficiency:Vitamin C is essential for
synthesis of collegen fiber. In vitamin C deficiency
fibroblast produce little collegen therefore,healing is poor
and delayed
• Zinc deficiency: Several enzymes are required for DNA
and RNA synthesis are zinc dependent. The deficiency of
zinc impairs DNAand RNA synthesis that leads to
impaired wound healing.
• Anemia: Low plasma protein and immunoglobins in
anemia impair healing process.
 Local infection
• Infection in the wound result in prolonged acute
inflamation and local tissue injury causing delay in wound
healing.
• Blood supply
• Poor blood supply slow healing process
• The cause of poor blood supply are the following:
ØPressure on the vessel
ØAntherosclerosis
ØVaricose veins