Physiology of Wound Healing
Inflammatory Phase
- Wound Healing cycle starts
- Lasts from injury to 4-6 days
- Edema, erythema, inflammation, pain
- Vessels form clots to prevent excessive loss of blood and fluids
- Platelets release growth factors to trigger healing process
- White cells go to area to "clean up"
Proleferative Phase
- Lasts 4-24 days
- Granulation tissue fills in wound
- Fibroblasts lay network of collagen in wound bed which gives strength to tissue
- Wound begins to contract - edges pull together
- Epithelial cells from wound margins migrate inward to cover wound
Maturation Phase
- Lasts 21 days to 2 years
- Begins when wound has filled in and re-surfaced
- Collagen fibers reorganize, remodel, and mature to give wound tensile strength forming scar tissue
- Scar tissue is only 80% as strong as original tissue.
Wound Care Protocols - Once the type and etiology of the wound has been identified, and the factors compromising wound healing have been addressed, management and care of the patient's wound is based on its classification. The protocol utilized depends on this classification. The type of advanced wound care product or technology used depends on the judgment of the wound care physician. Providing the optimal wound environment consists of aggressive debridement of necrotic tissue, identification and eradication of infection, obliteration of dead space, absorption excess drainage, providing protection and thermal insulation, and finally maintaining a moist wound environment.
Wound Classification - Based on the appearance of the wound it may be classified. Management is then determined by this classification. The following are classification examples:
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