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The body is a complicated and amazing mechanism, and the dynamic process of wound healing is an excellent illustration of how our body's many systems, in conjunction with the appropriate wound care products, work together to repair and replace devitalized tissues. But, exactly, how does our body heal?
When our skin is harmed, our bodies initiate an automatic series of actions known as the "cascade of healing" to restore the affected tissues. The healing process is classified into four overlapping stages: hemostasis, inflammation, proliferation, and maturation.
First Phase - Hemostasis Phase
Hemostasis, the initial stage of healing, begins when an injury occurs, with a goal to stop the bleeding. The body engages its emergency repair system, the blood clotting system, and constructs a dam to stop the drainage during this period. Platelets come into touch with collagen during this process, causing activation and aggregation. At the heart of the process is an enzyme called thrombin, which triggers the development of a fibrin mesh, which reinforces the platelet clumping and forms a durable clot.
Second Phase - Defensive/Inflammatory Phase
If Phase 1 is largely concerned with coagulation, the second phase, known as the Defensive/Inflammatory Phase, is concerned with eliminating germs and clearing debris, effectively preparing the wound bed for the creation of new tissue.
During Phase 2, neutrophils, a kind of white blood cell, enter the wound to eliminate germs and remove debris. These cells frequently achieve their maximal population between 24 and 48 hours after damage, then decline dramatically after three days. As the white blood cells leave, specialist cells known as macrophages come to finish the cleanup. In order to assist in tissue repair, these cells produce growth factors and proteins that recruit immune system cells to the wound. This phase typically lasts four to six days and is characterized by edema, erythema (reddening of the skin), heat, and discomfort.
Third Phase - Proliferative Phase
Once the wound has been treated, it enters Phase 3, the Proliferative Phase, when the focus is on filling and covering the wound.
The Proliferative phase is divided into three stages: 1) wound filling, 2) wound margin contraction, and 3) wound covering (epithelialization).
During the first stage, glossy, deep red granulation tissue forms new blood vessels and covers the wound bed with connective tissue. The wound margins compress and draw toward the center of the wound during contraction. In the third stage, epithelial cells emerge from the wound bed or edges and begin to migrate across the wound bed in a leapfrog pattern, eventually covering the wound with epithelium. The Proliferative phase might last anywhere from four to twenty-four hours.
Fourth Phase - Maturation Phase
The regenerated tissue gradually increases strength and flexibility throughout the Maturation period. Collagen fibers restructure, the tissue remodels and develops, and total tensile strength increases (though maximum strength is limited to 80 percent of the pre-injured strength). Maturation differs widely from wound to wound and can span anywhere from 21 days to two years.
The healing process is impressive and complicated, and it can be disrupted by local and systemic variables such as wetness, infection, and maceration (local), as well as age, nutritional condition, and body type (systemic). When the proper healing environment is created, the body heals and replaces devitalized tissue in remarkable ways.