Understanding the Healing Stages of Wounds
The wound healing stages are made up of three basic phases: inflammation, proliferation and maturation.
There are many types of wounds that require different wound care products for proper recovery from an ulcer or laceration, but most go through similar healing stages. The duration of each healing stage may vary according to factors such as tissue health, management methods and efficiency of the body’s immune system, but the medical community agrees that there are three main phases. Learn more about these healing stages to be better acquainted with the progress of your wound healing plan.
The first phase of healing is inflammation, the body’s natural response to trauma. After the wound has been inflicted, homeostasis begins – the blood vessels constrict and seal themselves off as the platelets create substances that form a clot and halt bleeding. Once hemostasis is achieved the blood vessels dilate, letting nutrients, white blood cells, antibodies, enzymes and other beneficial elements into the affected area to promote good wound healing and stave off infection. This is when someone would begin to experience the physical effects of inflammation – swelling, pain, heat and redness, according to the Australian Wound Management Association.
In the second wound healing stage, proliferation, the wound begins to be rebuilt with new, healthy granulation tissue. For the granulation tissue to be formed, the blood vessels must receive a sufficient supply of nutrients and oxygen. This new tissue is made up of a mixture of extracellular matrix and collagen, which allows for the development of a new network of blood vessels to replace the damaged ones (a process called angiogenesis), according to the AWMA. The color of the granulation tissue is an indicator of the health of the wound. For example, a reddish or pinkish color generally means that it is healthy, while a darker tissue is often an indicator of infection or inadequate delivery of blood to the wound bed.
In addition to developing granulation tissues, the body transforms damaged mesenchymal cells into fibroblasts, which serve as bridges that help cells move around the affected area. If your wound is healthy, these fibroblasts begin to appear within three days of the wound and will secrete liquids and collagen. This secretion helps to strengthen the wound site. During proliferation, the wound continues to grow stronger as the fibroblasts continually reorganize aiding in the development of new tissue and accelerate the healing process.
Maturation, also known as remodeling, is the last stage of the wound healing process. It occurs after the wound has closed up and can take as long as two years. During this phase, the dermal tissues are overhauled to enhance their tensile strength and non-functional fibroblasts are replaced by functional ones. Cellular activity declines with time and the number of blood vessels in the affected area decreases and recede.
While it may appear that the wound healing process is finished when maturation begins, it’s important to keep up the treatment plan. If the wound is neglected, there’s risk of it breaking down dramatically as it is not at its optimal strength. Even after maturation, wound areas tend to remain up to 20 percent weaker than they initially were.