Wound Healing

Introduction
❖ Wound:
⮚ A wound is defined as a separation or
discontinuity of the skin,mucous
membrane or tissue surface caused by
physical,chemical or biological insult.
❖ Healing:
⮚ Body’s response to injury in an attempt to
restore the normal structure & function.
Mechanism of healing
Wound healing occurs by two ways:

• Repair of tissues by regeneration

ex.destroyed cells are replaced by cells of
their own kind.
• By the process of substitution where
highly specialized cells are replaced by
less specialized connective tissue.
Repair of tissue by regeneration
• It is influenced by growth regulating factors
that help restoration of the lost tissue with
normal functioning cells.
• Tissues can be categorised according to
their mitotic capacity as
Renewing >epithelial and hemopoieitic cell
Expanding > bone and liver
static > neurones
• Among all tissues,skeletal muscles have
very limited power of regeneration
 Types of wound
healing by substitution
Healing by Primary intention
• It occurs in incised or surgical wounds with

> proper apposition of incised edges

> minimal bleeding
> least loss of tissue
> have good blood supply at edges
 cont…

• Narrow space between edges of wound

is first filled with blood clot.
• The capillaries start proliferating at
about 3rd day and by about 4th day
fibroplasia is evident and healing is
completed in about 5 to 14 days.
Secondary intention(healing
by granulation)

• It happens in wounds having extensive loss

of tissue and in wounds whose edges are
widely separated.
The granulation tissue consisting of budding
capillaries and fibroblasts grow from the
edges and bottom of the wound to fill up the
gap

Capillaries anastomoses with each other

and fibrous tissue proliferates.

Growth of fibrous tissue and capillaries

coming up to the surface of the wound
The surface epithelium also grows from its
borders and makes healing complete.

At later stage the fibrous tissue contracts,

causing constriction and obliteration of
capillaries giving characteristic pale colour
of scar tissue or cicatrix.
Tertiary intention
When a wound is intentionally
kept open to allow edema or infection to resolve
or to permit removal of exudate, the wound
heals by tertiary intention, or delayed primary
intention. These wounds result in more scarring
than wounds that heal by primary intention but
less than wounds that heal by secondary
intention.
Phases of wound
healing
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