This document discusses wound healing, defining it as a complex process to restore cellular structures and tissue layers. It describes the two types of wound healing as primary and secondary. Secondary wound healing occurs when there is extensive tissue destruction or when the wound edges cannot be approximated, as in pressure ulcers. The phases of secondary wound healing are the same as primary healing: inflammatory phase, proliferation phase, and maturation phase. Complications and factors affecting wound healing are also discussed.

1. SECONDARY
WOUND HEALING
Arjun kumawat
M.Sc.Nsg 1st yr

2. OBJECTIVES
 Discuss small information about wound healing
 Definitions wound healing
 Enlist the types of wound healing
 Explain the phases of wound healing
 Describe the complication and factors affecting
wound healing.

3. DEFINITION
 Wound healing is a complex and
dynamic process of restoring
cellular structures and tissue
layers.
 Types:-
1.Primary healing
2. Secondary healing
Wound

4. SECONDARY WOUND HEALING
 This method of healing follow destruction of
large amount of tissue or when the edges of a
wound cannot be brought into apposition,
eg.pressure ulcer .
The phases of secondary healing are the
same as in primary healing and the time taken for
healing depends on the effective removal of the
cause and the size of the wound.

5. PHASES
 The phases of wound healing are:-
1. Inflammatory phase
2. Proliferation phase
3. Maturation phase

6. 1.INFLAMMATORY PHASE
 It is initiated immediately after injury and lasts 3-6
days. Two major processes occur during this
phase: hemostasis and phagocytosis.
The body has stopped any further blood loss
by coagulating (clotting.) Once the blood loss has
stopped, the body immediately sends fluids
containing plasma proteins, blood cells and
antibodies to the wound site causing swelling, pain,
fever, and redness around the wound site.

7. CONT…….
 Neutrophils and macrophages are also
dispatched to the injury site to clean, scavenge for
bacteria and prepare the injury site for healing.
The injured site will be swollen
and painful because of the inflammation; most of
the pain will subside when the inflammation
reduces naturally.

8. 2.PROLIFERATION PHASE
 This stage overlaps with the ending of the
Inflammatory Phase .
 Fibroblasts have begun to enter and collect in the
wound by around day 3 after the injury; this marks
the start of the transition from Inflammatory Phase
to Proliferation Phase.

9. CONT….
 Granulation tissue (it consists of new blood vessels,
fibroblasts, inflammatory cells, endothelial cells and the
components of a new extracellular matrix) will begin to be
seen in the wound by the end of the first week, this tissue
will continue to grow until the wound is healed.
 This tissue contains the new blood vessels and other
components to fill in the damaged tissue.

10. CONT….
 Granulation tissue is normally bright red, moist, soft
to the touch, and has a bumpy appearance.
 This takes approximately 8 weeks for a standard
open healing excision wound and 4 weeks for a
closed wound.

11. 3.MATURATION PHASE( REMODELING)
 This stage overlaps with the Proliferation Phase
towards the end of healing. It is the process of
remodeling of the collagen fibres laid down in the
proliferation phase. Nerve endings are re-growing
and tissue is rearranging itself.

12. CONT….
 In short, there is a lot of activity still happening long
after your wound has healed on the surface. You
may continue to feel tugging and tension from deep
inside the wound for quite a while as the new tissue
stabilizes.

14. Complication
and factors
affecting wound
healing

15. SUMARIZATION
 Wound healing is a complex and dynamic process
of restoring cellular structures and tissue layers.
The human adult wound healing process can be
divided into 3 distinct phases: the inflammatory
phase, the proliferative phase, and the remodeling
phase.

16. BIBLIOGRAPHY
 Barbara kozier, fundamentals of nursing, edition
7th,publisher pearson, page no 860-865.
 Roos and Wilson, anatomy and physiology, edition
11th, pub Elsevier, page no 359-362.
 Gerard j.tortora & bryan H. derrickson, principles of
anatomy and physiology, edition 12th,pub john
wiley, page no 162-164.
 http://www.biology-online.org/dictionary/Dna.
 http://www.answers.com/topic/dna.
 http://en.wikipedia.org/wiki/Chromoso