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Wound healing

Share Like Subscribe Wound It is a circumscribed injury which is caused by external force and it can involve any tissue and organ. A wound is a break in the integrity of the skin tissues often which may be associated with disruption of the structure and function. A cut or break in the continuity of any tissue caused by injury or operation. Classification of wounds. Tidy wounds and untidy wounds. Classification based on type of wound Clean incised wound Lacerated wound Bruising and contusion Haematoma Puncture wound Abrasion Crush injury Injures to bone and joint(may be open or closed) Injuries to nerve( either clean cut or crush) Injuries to arteries and veins Penetrating wounds. Classification based on thickness of wound Superficial wound Partial thickness Full thickness Deep wounds Complicated wounds Penetrating wounds Classification of surgical wounds Clean wound Clean contaminated wound Contaminated wound Dirty infected wound HEALING Healing is the body’s response to injury in an attempt to restore normal structure and function. The process of healing involves 2 distinct processes Regeneration and repair 1 Regeneration is when healing takes place by proliferation of parenchymal cells and usually results in complete restoration of the original tissues. The goal of all surgical procedures should be regeneration which returns the tissues to their normal microstructure and function. 2 Repair . It is a healing outcome in which tissues do not return to their normal architecture and function. Repair typically results in the formation of scar tissue. Types of wound healing Healing by first intention(wounds with opposed edges) Healing by secondary intention( wounds with separated edges) Healing by first intention( wounds with opposed edges) Healing of wound with following characteristics Healing of wound with following characteristics Clean and uninfected Surgically incised Without much loss of cells and tissue Edges of wound are approximated by surgical sutures Wounds with opposed edges Primary union With in 24 hours Neutrophils appears at margin of incision. Epidermis thickens. In cut layer of the dermis thin epithelial layer forms. By day three. Neutrophils replaced by macrophages. Epithelial cell proliferation continues thickening epidermal covering layer. By day five Incisional space is filled by granulation tissue Neovascularization is maximal Collagen fibrils become more abundant and begin to bridge incision Epidermis recover it s normal thickness and differentiation of surface cells yiels a mature epiderma architecture with surface keratinization. During the second week Continued accumulation of collagen and proliferation of fibroblasts. Leukocytic infiltrate, edema and increased vascularity have largely disappeared. By the end of the first month. Scar comprises a cellular connective tissue devoid of inflammatory infiltrate covered now by intact epidermis. Dermal appendages that have been destroyed in the line of the incision are permanently lost. Tensile strength of the wound increases thereafter mut it may take months for the wounded area to obtain it maximal strength. Healing by secondary intention Wounds with separated edges Secondary union When there is more extensive loss of cells and tissue. Regeneration of parenchymal cells cannot completely reconstitute the original architecture. Abundant granulation tissue grows in from the margin to complete the repair. Secondary healing differs from primary healing in several respects Inflammatory reaction is more intense Much larger amounts of granulation tissue are formed Wound contraction occurs inlarge surface wounds. Substantial scar formation and thinning of the epidermis occurs. #health #medical #nurse