Wound healing is a fundamental recovery process in surgical pathology, which depends on many factors, the extent and nature of the injury, the body’s resistance and treatment.

People can get injured for a variety of reasons, from a small cut to major injuries like surgery. No matter what the damage is, our bodies have the right way to heal.

1. The healing process

Wounds are injuries that break or break the skin or mucous membranes and other parts of the body. Wound healing is a fundamental recovery process in surgical pathology, which depends on many factors, the extent and nature of the injury, the body’s resistance and treatment. This process consists of four stages:

  • Hemostasis phase
  • Inflammatory phase
  • The proliferative phase
  • Regeneration phase

– Hemostasis phase

This is the stage that occurs immediately after the wound appears. Damaged blood vessels immediately constrict to reduce blood flow and limit blood loss. The platelets and clotting factors are then activated to form a clot. The clot blocks the damaged blood vessel and stops bleeding. If the wound is not too wide, the clot should seal the lesion firmly within 3-6 minutes. In case the wound is too deep or too large to prevent blood clots from forming, it is necessary to apply measures to prevent bleeding from the outside such as bandages, gauze, garo.

– Inflammatory phase

This phase occurs concurrently with the hemostasis phase and usually lasts 4-6 days, possibly longer for chronic wounds. This stage is characterized by symptoms such as swelling, heat, redness, and pain. At this stage, white blood cells are mobilized to the injury site to destroy and prevent bacteria from growing. About 4 days after injury, macrophages are also involved in the destruction of bacteria and cleaning of cell debris from the wound. In addition, macrophages also produce cytokines and chemicals that attract other cells involved in the repair of damaged tissues.

– Proliferative phase

The proliferative phase usually lasts several weeks. At this stage, the wound will develop stem granulation tissue including fibroblasts and neovascular network thanks to the migration and proliferation of endodermal cells. In addition, fibroblasts also pull tissues to the center, helping to heal wounds and limit scarring.

– Regeneration phase

This is the final stage of the healing process, usually starting from the 21st to several months or years. This phase helps restore tissue integrity and function. Not only that, it also determines the shape of the wound after the healing process is complete. If this stage is fast and strong, it can cause the wound to form a keloid scar, and vice versa, a concave scar can be formed.

– Factors affecting the healing process

There are many factors that affect the healing process such as the size, depth of the wound, the care, treatment, nutrition and condition of the patient. Small, shallow wounds heal more easily than large, deep wounds. Wounds that are heavily crushed and dirty will heal more slowly than flat and clean wounds. The elderly, have chronic diseases such as diabetes, cardiovascular, chronic respiratory, blood clotting disorders, or those who are being treated with corticosteroids, anticoagulants, those who are exhausted, malnourished. nursing, … the wound will heal more slowly. In addition, improper wound care is also one of the causes of delayed wound healing.


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