# 33

# 33 discuss the stages of wound healing:

There are four stages of wound healing.

Stage 1—Inflammatory process occurs; blood vessels constrict, providing a clot; vasodilatation brings more nutrients and WBC’s to wound; blood flow is re-established after epithelial cells begin to grow. A slight fever is normal.

Stage 2—Collagen and granulation tissue forms in the wound.

Stage 3-- Collagen fibers strengthen the wound; scar is pink and raised.

Stage 4—Scar becomes smaller, flatter and white

I also found the following; I am not sure just which info. Semillo is looking for here, so I will post both.

Wounds heal by one of three processes: primary, secondary or tertiary intention.

Primary Healing—wound with little tissue loss, edges approximated (close together), heals rapidly with minimal scarring, low risk of infection (i.e.: surgical incisions), healing in the Primary intention takes place in three ways:

Inflammatory phase (reaction)—begins within minutes and lasts about three days. Reparative processes control bleeding, deliver blood and cells (leukocytes) to the area, and form epithelial cells at the site of the wound.


Proliferative Phase (regeneration)—begins with the appearance of new blood vessels, lasts from 3 to 24 days. The wound fills in with connective or granulation tissue and the top is closed by epithelization. Fibroblasts synthesize collagen, which closes the wound defect.

Maturation (Remodeling)-- The collagen scar continues to gain strength. The collagen fibers undergo remodeling (reorganization) before assuming their normal appearance. This process may take more than a year, depending on the extent of the wound.

Secondary Healing--- Wounds involving loss of tissue; wound edges widely separated; wound appears pink to dark red; healing occurs by granulation resulting in a large scar, increased likelihood of infection, healing time is longer (i.e.-burns, pressure ulcers).

Tertiary Healing-- Occurs when a widely separated wound is later brought together with some type of closure material. This type of wound usually is fairly deep and likely to contain extensive drainage, and tissue debris. These wounds have a high risk of infection (i.e.-wound dehiscence).

ATI Fundamentals book. pg 233