WOUND

HEALING
 God heals, and the doctor
takes the fees

Benjamin Franklin(American Statesman, scientist, Philosopher)

Cutaneous Wound Healing

1. By Primary Intention

2. By Secondary Intention

3. By Tertiary Intention
 Secondary Union differs from
Primary Union by:

Larger clot or scab rich in fibrin or fibronectin

More intense inflammation

Much larger amounts of granulation tissue formed

Involves wound contraction

Phases of Healing

Inflammatory (Reactive)
Haemostasis Inflammation

Proliferative (Regenerative/Reparative)
Epithelial migration proliferation Maturation

Maturational (Remodeling)
Contraction scarring Remodeling
 Process of Healing

The phases of wound healing are:

Inflammatory phase

Proliferation phase

Maturation phase
Inflamatory Phase

1.Immediate to 2-5 days.

2.Bleeding stops(haemostasis)
Constriction of blood supply.
Platelets start to clot .
Formation of a scab.
3.Inflamation
Opening of the blood supply
Cleansing of wound.
It is at this stage that the characteristic signs of inflammation
can be seen; erythema, heat, oedema, pain and functional
disturbance.
 Proliferative phase

1.5 days to 3 weeks

2.Granulation
New collagen tissue is laid down.
New capillaries fills in defect.
3.Contraction
Wound edges pull together.
4.Epithelialization
Cells cross over the moist surface.
Cell travel about 3 cm from point of orgion.
 Maturatin phase
1.Collagen forms which incrases
tensile strength to wound healing.
2.Scar tissue is only 80% as stong
as
original tissue.
3. 3 weeks to 2 years.
Factors affecting Wound Healing
Infection
Nutrition ( proteins, vit.C, vit.A, Zn, Fe)
Steroids(after 4-5 days)
Mechanical factors
(a) Increased pressure/torsion)
(b) Ischemia
Advanced age
Radiation (after 4-5 days).
Diabetes Mellitus
 Growth Factors in Wound Healing

Increase size of cells

Increase number of cells

Inhibit apoptosis

Pleiotropic effects i.e initiate cell proliferation, migration,

differentiation, contractility, enhance synthesis of specialized
proteins eg. Collagen in fibroblasts
 HONEYSOFT

Natural dressing
Honey-impregnated dressing
Chronic unhealing wounds.
Impregnated into a compress of
EVA (ethylenevinylacetate) mesh
Honey cleans the wound without
disturbing it
Removing the dressing causes no
damage
no known side effects