What are the types of wound healing?

What are the types of wound healing?

Wound healing is a complex and fascinating process that occurs when the body’s tissues are damaged. Our bodies have a remarkable ability to repair themselves, and wound healing is a crucial part of this regenerative process. In this article, we will explore the different types of wound healing and understand the mechanisms behind each one. Whether you’ve experienced a minor cut or a more severe injury, this knowledge will help you appreciate the remarkable nature of the healing process.

When the skin is injured, there are three choices for healing. Primary, secondary and tertiary healing paths will be determined by the wound characteristics. Your doctor will help make the best possible choice to facilitate healing. Once the healing intention is determined, the wound will continue to progress through the four phases of healing.

Three types of healing

  • Primary intention healing occurs when the wound edges are in close proximity or have been precisely reapproximated using medical interventions like sutures, staples, or adhesive strips. This type of healing is typically observed in surgical incisions or clean, well-aligned lacerations. The wound is closed, minimizing the gap between the edges, and the healing process is rapid and efficient. It involves three distinct phases: inflammatory, proliferative, and remodeling. With the wound edges approximated, there will be no proliferative phase needed for granulation tissue formation.
  • Secondary intention healing is the process of wound healing when there is a significant gap between the wound edges or when the wound is left open intentionally. This type of healing is often observed in large wounds, deep lacerations, or when an infection is present. The healing process is slower compared to primary intention healing, as it involves the formation of granulation tissue, contraction, and epithelialization to close the wound gradually. The wound bed is often packed to fill the open cavity to allow for granulation tissue to fill the space.
  • Also known as delayed primary closure, tertiary intention healing combines aspects of both primary and secondary intention healing. This type of healing occurs when a wound is initially left open, allowing it to heal by secondary intention, but is later closed through surgical intervention. Tertiary intention healing is often used when there is an increased risk of infection or when the wound needs to be monitored closely before closure. It can be seen in cases of contaminated or infected wounds. Negative Pressure Wound Therapy may be an advanced healing modality used initially to prepare a wound for surgical healing.

Four phases of healing

Before the actual wound-healing process begins, the body initiates a phase called hemostasis. Hemostasis aims to stop the bleeding and involves blood clot formation, vasoconstriction, and platelet aggregation. This initial response is vital for the subsequent healing phases to take place effectively. Hemostasis happens normally within a few minutes or hours.

 

The inflammatory phase is the body’s natural response to tissue injury. It involves the activation of immune cells, the release of inflammatory mediators, and the initiation of the healing process. During this phase, white blood cells clean the wound of debris, bacteria, and foreign substances, while inflammation helps to control infection and prepare the wound for the next phase. There will be mild swelling and redness during this phase which is normal and necessary that should not be confused with signs of infection. An infection will have a much greater response that continues to worsen if left untreated.

 

New tissue is generated to fill the wound space during the proliferative phase. The wound is rebuilt with the formation of granulation tissue, which consists of new blood vessels, collagen, and fibroblasts. This tissue is not the same as the original tissue but will fill in to form the scar. Epithelial cells at the wound edges begin to migrate, gradually closing the wound. This phase is characterized by the formation of new blood vessels or angiogenesis), collagen synthesis, and wound contraction. Re-epithelialization and proliferation phases are synonymous.

 

The final phase of wound healing is the remodeling phase. During this phase, the newly formed collagen fibers reorganize and realign themselves, increasing the strength and integrity of the healed tissue. This process can take months to years, and the scar tissue gradually becomes more organized and resembles the surrounding tissue, although never quite gaining full strength.

 

Wound healing is a complex and dynamic process that involves various cellular and molecular mechanisms. Understanding the different types of wound healing can provide valuable insights into how our bodies repair themselves after an injury. Whether it’s a small cut or a more severe wound, our bodies possess remarkable restorative capabilities. By appreciating the intricacies of wound healing, we can better care for our injuries and support the body’s natural process of regeneration. 

©2020 Human Biosciences, Inc. The content presented here is for your information only. It is not a substitute for professional medical advice.