The document summarizes wound healing and skin grafting. It describes the process of healing for open and approximated wounds, including hemostasis, inflammation, granulation tissue formation, wound retraction, and tissue remodeling. It also discusses scar formation and maturation. Skin grafting involves transplanting skin to treat extensive wounds, burns, or skin loss, and the grafted skin undergoes healing after transplantation.

1. HEALING OF
OPEN AND
APPROXIMATED
WOUND
PRESENTED BY
Aheed Khan
Roll number-8

2. The Skin

3. Open wounds are:-
1. Puncture wounds
2. Abrasions
3. Friction burns
4. Lacerations
5. Bites

4. Process of Healing
1. Hemostasis and inflammation
• recruitment of growth factors for
regeneration and WBCs - fighting off
potential infection
• The stem cells proliferate to replace the
damaged tissue

6. Granulation tissue
• Granulation tissue-numerous blood
vessels, edema, loose extracellular matrix
containing occasional inflammatory cells.
• The extent of angiogenesis and fibroblast
proliferation -the extent of injury
• If the wound is clean-the granulation tissue is
less, but if its dirty and large- greater amount
of granulation tissue is formed.

7. Primary Secondary

8. Granulation tissue

9. Wound retraction
1. Wound contractions -in union by secondary
intention - the injury and the granulation
tissue formed was large.
2. Myofibroblast start to develop at the edge of
the wound which then function as smooth
muscle cells causing wound contraction

10. Primary Secondary

11. Tissue remodeling
• replacement of granulation tissue by normal
extracellular matrix.
• help of various chemicals secreted by
macrophages such as
metalloproteinases, disintegrins and
gelatinases.
• Subsequently the rate of degradation subsides
and collagen accumulation starts to regain
tensile strength.

12. Role of macrophages in wound healing
PDGF, TGF-β, IL-1
MMPs, TNF, TGF
VEGF,PDGF
Phagocytosis, collegenase
Nitric
Acid
Removal of debris angiogenesis
Tissue Remodelling
Antimicrobial activity
Chemotaxis &
fibroblast proliferation

13. in toto

14. Treatment objectives
• Stop bleeding
• Cleaning of the wound
• Surgical debridement
• Radiological examination

15. Approximated wounds are:-
1. Surgical wounds
2. Neat cuts from
sharp objects

16. Healing of an approximated wound
• An approximated wound heals by primary
intention
• Less granulation tissue
• Less inflammation
• Fast recovery with no or minimal infection

18. Scar formation
• Occurs when injury is deeper to superficial
dermis
• Maturation phase--> disorganization of
collagen

19. Scar maturation
• Remodelling takes place over 6-12 months
• Immature scars mature over an year

20. Skin grafting
• surgery involving the transplantation of skin
• used to treat:
1. Extensive wounding or trauma
2. Burns
3. Areas of extensive skin loss

21. After skin grafting