Wound healing is a complex physiological process involving distinct phases: inflammation, proliferation, and remodeling, aimed at restoring tissue integrity after injury. Various local and systemic factors can influence wound healing, and impaired healing can lead to chronic wounds or excessive scarring. Understanding the mechanisms and complications of wound healing is crucial for effective diagnosis and treatment strategies.

1. PATHOLOGY FOR NURSES
WOUND HEALING
Dr. Binu Babu
Ph.D (N)
Professor
Mrs. Jincy Ealias
M.Sc (N)
Professor

2. WOUND HEALING
• Wound healing is the physiological process by which the body repairs
damaged or injured tissue. It involves a series of complex and
coordinated events aimed at restoring the structural and functional
integrity of the affected area.
• The ultimate goal of wound healing is to restore the barrier function of
the skin or synthesis and deposition of extracellular matrix
components, such as collagen, to strengthen the wound.

3. • In pathology, wound healing refers to the study of the biological
processes that occur in response to tissue injury or damage.
• Understanding wound healing in pathology involves examining the
cellular and molecular mechanisms involved in repairing and
restoring the integrity of damaged tissues.

4. PHASES OF WOUND HEALING
• Wound healing typically progresses through distinct stages, including
Proliferation Remodeling
Inflammation

5. Inflammatory Phase:
• Initiated immediately after injury.
• Characterized by releasing inflammatory mediators, such as histamine, prostaglandins, and
cytokines.
• Neutrophils and macrophages migrate to the injury site to remove debris and pathogens.
Proliferative Phase:
• Begins within a few days of injury.
• Involves the proliferation and migration of various cell types, including fibroblasts,
endothelial cells, and keratinocytes.
• Formation of granulation tissue provides a scaffold for cell migration and angiogenesis.
• Synthesis and deposition of extracellular matrix components, such as collagen, to strengthen
the wound.

6. Remodeling Phase:
• Begins several weeks after injury and can last for months to years.
• Characterized by the remodeling of the extracellular matrix and the maturation of scar tissue.
• Collagen fibers undergo reorganization and cross-linking to increase tissue strength.
• Reduction in vascularity and cellularity of the scar tissue.

7. FACTORS INFLUENCING WOUND
HEALING
• Local Factors:
• Size, depth, and location of the wound.
• Presence of infection or foreign bodies.
• Blood supply to the injured area.
• Degree of tissue damage and inflammation.
• Systemic Factors:
• Age: Wound healing tends to be slower in elderly individuals.
• Nutrition: Adequate intake of nutrients, especially proteins and vitamins, is essential for
optimal wound healing.
• Chronic diseases: Conditions such as diabetes, vascular disease,and immunodeficiency
can impair wound healing.

8. DISORDERS OF WOUND HEALING
Impaired Healing:
• Delayed wound heating: Prolonged inflammatory phase or impaired proliferation and
remodelling.
• Chronic wounds: Fail to progress through the normal phases of healing, often due to
underlying systemic or local factors.
• Excessive scarring: Hypertrophic scars or keloids, characterized by excessive deposition of
collagen.
Pathological Healing:
• Fibrosis: Excessive deposition of collagen leading to tissue fibrosis and loss of function.
• Contractures: Abnormal wound contraction resulting in deformity and restricted movement.
• Chronic non-healing ulcers: Persistent wounds that fail to heal despite appropriate treatment.

9. DIAGNOSTIC TECHNIQUES:
Histological Examination:
• Assessment of tissue sections to evaluate the progression of wound
healing and identify any abnormalities.
• Staining techniques to visualize cell types, extracellular matrix
components, and inflammatory infiltrates.

10. CLINICAL IMPLICATIONS
Treatment Strategies:
• Surgical interventions to debride wounds, close tissue defects, or promote healing,
• Topical treatments, dressings, and wound care techniques to optimize wound healing,
• Pharmacological interventions to modulate inflammation, promote angiogenesis, or
enhance collagen synthesis.
Prevention and Management of Complications:
• Identification and management of factors that impair wound healing, such as infection,
poor nutrition, or underlying chronic diseases.
• Monitoring and management of chronic wounds to prevent complications such as
infection or amputation.

11. SUMMARY
• Wound healing in pathology involves a complex interplay of cellular
and molecular processes targeted to restore tissue integrity followed by
an injury.
• Recognizing different phases, factors influencing healing, and
disorders of wound healing, diagnosing, managing, and preventing
complications associated with impaired or pathological wound healing.

12. REFERENCES
• Suresh K Sharma. Textbook of Pharmacology, Pathology and Genetics for Nurses
(Vol-I) Jaypee Brothers Medical Publishers.
• Swaminathan K, Pathology and Genetics for Nurses, Jaypee Brothers Medical
Publishers.
• Ramdas Nayak, Sharada Rai & Astha Gupta. Textbook of Pathology and Genetics
for Nurses, Jaypee Brothers Medical Publishers.
• Mandal AK & Shramana Choudhary. Comprehensive textbook of Pathology for
Nursing, Avichal Publishers.
• Vinay Kumar, Abbas A K, Aster C J, Robbins & Cotran Pathologic Basis of Disease,
ELSEVIER.