There are different types of wound healing described in this slides

1. Dr Ardra Thorat
MS Shaltatantra

2. Wound healing
 Replacement of destroyed tissue by living tissue
1. Regeneration- replacement of lost tissue by similar
type of tissue
2. Repair- replacement of lost tissue by granulation
tissue, followed by fibrosis & scar formation,
8/1/2020 Dr Ardra Thorat

3. Definition of wound healing :-
 Wound healing is process by which skin or other
body tissue repairs itself after trauma
 In undamaged skin, the epidermis and dermis
form a protective barrier against the external
environment.
8/1/2020 Dr Ardra Thorat

4. General principle of
wound healing
8/1/2020 Dr Ardra Thorat

5. Healing by 1st intention
 When wound sutured primarily
 Minimal scar
8/1/2020 Dr Ardra Thorat

6. Healing by 2nd intention
1. When there is irreparable skin loss
2. when the wound becomes infected and breaks
open
3. primary suturing is not possible, so the wound
heals with more scar tissue and takes longer time
to heal.
8/1/2020 Dr Ardra Thorat

7. Wound healing processes
 Rapid hemostasis
This refers to the mechanism that stops the actual
bleeding. Most of the time, body will accomplish this
through a process called vasoconstriction.
 Following processes take place
a) Inflammation
b) Wound contraction
c) Epithelization
d) Granulation tissue formation
e) Scar remodeling
8/1/2020 Dr Ardra Thorat

8. 1. Inflammation
trauma
Platelet become adherent
Vasoconstriction
Vasodilatation( Histamin)
Prostaglandin PEG1, PEG2
Local inflammatory vascular response
8/1/2020 Dr Ardra Thorat

9. 2. Wound contraction
 Open wounds, after 3-5 days
 Amount of contraction depends upon amount of skin
available
 Causes – removal of fluid, contraction of collagen,
contraction of granulation tissue
 Inhibiting factors-
a) Corticosteroid
b) burns
c) immediate skin grafting
d) X ray irradiation
e) cytotoxic agents
8/1/2020 Dr Ardra Thorat

10. 3 Epithelization
 Epidermis grows
 It forms edges of wound by process of cell migration and
cell multiplication.
 This is mainly brought about marginal basal cells
proliferation
 Thus within 48 hours entire wound is re- epithelialised.
 When there is wound with skin loss, skin appendages, also
help in epithelisation , surface cells get keratinised.
8/1/2020 Dr Ardra Thorat

11. 4.Grannulation tissue formation
1) Mainly formed by proliferation & migration of surrounding
connective tissue element.
2) Stage of vascularization
3) Stage of devascularization- Fibroplasia along with capillary
budding gives rise to granulation tissue.
4) Between third and fifth day, polymorphoneuclear leukocytes
diminish in number but monocytes increases. They are
specialised scavengers.
5) By fifth or sixth day, fibroblasts appers, proliferate and
eventually gives rise to protocollagen which is converted into
collagen in presence of enzyme, protocollagen hydroxylase,
oxygen, ferrous ions and as corbic acid are neccessory for
this step.
8/1/2020 Dr Ardra Thorat

12. 5. Scar remodeling
Following changes take place during scar formation
–
1) Fibroplasia and laying of collagen is incresed.
2) Vascularity becomes less.
3) Epithelialisation continues.
4) Remodeling of collagen take place with
cicatrisation resulting in scar.
8/1/2020 Dr Ardra Thorat