Wound healing is a complex process that restores integrity and function. It involves inflammation, formation of granulation tissue and blood vessels (angiogenesis), and remodeling. There are three main stages - coagulation, inflammation, and fibroplasia/formation of fibrous tissue. The healing process takes different times depending on the severity, with minor wounds healing in 1-2 weeks and more extensive wounds taking 4 weeks. There are three types of wound healing - primary intention (minor wounds closed with stitches), secondary intention (larger wounds healed from bottom up), and tertiary intention (delayed closure after 4-6 days).

1. WOUND HEALING
Wound healing is a complex cellular and biochemical
process that leads to restoration of integrity and function
of a cell.
Although individual tissues may have unique healing
characteristics but all the tissues undergo same or similar
mechanism of healing.

2. WOUND HEALING PROCESS
TIME PROCESS
24 hrs Neutrophils at the place migrate towards the fibrin
clot.
24-48 hrs Basal epidermal cell starts to migrate and proliferate
& it forms a continuous epithelial layer.
Day 3 Neutrophils are replaced by macrophages, fibroblast
& collagen fiber are evidented. Epithelial cells
continues to proliferate & forms the epidermal
covering layer

3. TIME PROCESS
Day 5
Granulation tissue fills the insertion space.
Collagen fibers become more abundant & bridges
to cover insertion.
Week 2
Accumulation of collagen and fibroblast
proliferation. In this stage edema & leukocyte are
suppressed.
Week 4
This scar is composed of fibrous connective tissue
with few inflammatory mediators. Strength of the
tissue continues to increase with tissue.

4. MECHANISM OF WOUND HEALING
ACUTE WOUND
COAGULATION
INFLAMMATION
FIBROPLASIA
[fibrous tissue formation]
Granulous
tissue
formation

5. ANGIOGENESIS
[formation of new blood]
REMODELLING
HEALED WOUND

6. TYPES OF HEALING
Healing by Ist intension:
• Very less severe wound.
• This type oh healing is used when the severity is very low
or less severe. This healing can be done with stitches, skin
glue, tapes. This kind of closure is used when there is very less
tissue loss.
• Eg: small surgical insertion or accidental small cuts.
Healing by IInd intension:
• When the wound is extensive and involves considerable
tissue loss and in which edges cannot be joined together.
• This healing differs from first intension in 3ways. The repair
time is longer. The scarring time is greater. The chances of
infection is greater.
• This wound heels from bottom to top. It spontaneously heels
when the dermal base is protected.

7. Healing by IIIrd intension:
• It is also known as delayed or secondary closure and it
is indicated when there is a reason to delay the suture or
closing a wound.
• Eg: When there is poor circulation in the injured area,
the edges are closed 4-6 days after meticulous
debridement [cut and removing the unwanted tissue]