Wound Healing capped is to clean up the debris.
This is a
• When a wound occurs, the body
responds witha predictable series of
events to repair the resulting damage.
• This inevitable response can be divided
into four distinct phases—hemostasis,
inflammation, repair, and remodeling
• Typically ending in scar formation. Each
phase is characterized by the interaction
of cells and molecules, resulting in a
complex series of events that change the
morphology and characteristics of the
wounded area.
• In recent years, biological research has
greatly expanded our understandingof
the intricate processes involved in
wound repair
3 phases of Wound healing
1. Hemostasis:
• The wound healing process begins
immediately after injury. During injury,
the tissue is disrupted and blood vessels
are severed, releasing blood plasma and
peripheral blood cells intothe wound site.
• The earliest signals of tissue injury are
the release of molecules such as ATP and
the exposure of collagen on the blood
vessel wall.
• A clot is then formed and acts as
atempo- rarybarrier, preventing excess
bleeding and limiting the spread of
pathogens into the bloodstream
• Once the source of damage to a house
has been removed and before work can
start, utility workers must come in and
cap damaged gas or water lines.
• So too in wound healing damaged blood
vessels must be sealed. In wound
healing the platelet is the cell which acts
as the utility worker sealing off the
damaged blood vessels.
• The blood vessels themselves constrict
in response to injury but this spasm
ultimately relaxes. The platelets secrete
vasoconstrictive substances to aid in this
2. Inflammation Phase:
• Clinically inflammation, the second stage
of wound healing presents as erythema,
swelling and warmth often associated
with pain, the classic “rubor et tumorcum
calore et dolore”.
• This stage usually lasts up to 4 days post
injury. In the wound healing analogy the
first job to be done once the utilities are
job for non-skilled laborers.
• These non-skilled laborers in a wound are
the neutrophils or PMN’s
(polymorphonucleocytes).
• Neutrophils, the most common type of
leukocyte,
are the first inflammatory cells recruited to
the wound, and arrive within 24 hofinjury.
• They migrate into the wound by responding
to chemo- attractants released by platelets
as well as chemo- kines presented on
endothelial cell membranes
• The inflammatory response causes the
blood vessels to become leaky releasing
plasma and PMN’s into the surrounding
tissues.
• The neutrophils phagocytize debris and
microorganisms and provide the first line of
defense against infection. They are aided by
local mast cells. As fibrin is broken down as
part of this clean-up the degradation
products attract thenext cell involved.
The task of rebuilding a house is complex and
requires someone to direct this activity or a
contractor. The cell which acts as “contractor” in
wound healing is the macrophage. Macrophages
are able to phagocytize bacteria and provide a
second line of defense. They also secrete a variety
of chemotactic and growth factors such as
fibroblast growth factor (FGF), epidermal growth
factor (EGF), transforming growth factor beta (TGF-
__ and interleukin-1 (IL-1) which appears to direct
the next stage5.
Proliferative Phase ( Proliferation,
Granulation and Contraction):
• The granulation stage starts approximately
four days after wounding
• usually lasts until day 21 in acute wounds
depending on the size of the wound.
• It is characterized clinically by the presence
of pebbled red tissue in the wound base and
involves replacement of dermal tissues and
sometimes subdermal tissues in deeper
wounds as well as contraction of the wound
• The “framer” cells are the fibroblasts which
secrete the collagen framework on which
further dermal regeneration occurs.
Remodeling or Maturation Phase:
• Once the basic structure of the house is
completed interior finishing may begin.
• In wound repair the healing process involves
remodeling the dermal tissues to produce
greater tensile strength. The principle cell
involved in this process is the fibroblast.
 • Remodeling can take up to 2 years after
wounding and explains why apparently
healed wounds can break down so
dramatically and quickly if attention is
not paid to the initial causative factors.
nerve endings in the skin have been
destroyed. In the case of burns caused by
electricity, there may be wounds at entry
and exit sites.

BURNS
First-degree burns
• are the least severe. They affect only the
outer layer of the skin. The person may
experience tingling and hypersensitivity
of the skin. There may be pain that is
soothed by cooling measures. The wound
may appear reddened, but turn white
briefly when pressed. The area is dry,
with little or no swelling.

Second-degree burns
• affect both the outer and underlying
layers of skin. Symptoms include pain,
redness, swelling, and blistering. The
wound may have a weeping surface.

Third-degree burns
• -cause the deepest damage. The skin is
affected. Subcutaneous tissue,
connective tissue, muscle, or bone may
also be damaged.
• The surface of the burn may be white
and soft, or black, charred, and leathery.
The burned area has no feeling when
touched.
• usually are not painful because the