Although the stages of wound healing are linear, wounds can progress backward or forward depending on internal and external patient conditions. The four stages of wound healing are:
Hemostasis phase (takes 1-3 days): The first process of wound healing is hemostasis. It is the process of the wound being quickly closed by clotting.
Inflammatory phase (takes less than 1 week): Inflammation helps controlling bleeding and preventing infection. During the inflammatory phase, damaged cells and pathogens are removed from the wound area by white blood cells (leukocytes) and macrophage cells. During this phase, the swelling, heat, pain and redness are commonly seen.
Proliferative phase (takes 2-3 weeks): The proliferative phase of wound healing happens when the wound is rebuilt with new tissue made up of collagen and extracellular matrix. A new network of blood vessels will be constructed, so granulation tissue can be healthy and receive sufficient oxygen and nutrients. Collagen deposition subsequently happens to increase the strength of the wound.
Maturation phase or remodeling phase (takes up to years): During the maturation phase, collagen is aligned along tension lines and water is reabsorbed. Cross-linking of collagen reduces scar thickness and also makes the skin area of the wound stronger.
Since the stages of wound healing are complicated, failure to progress in the stages of wound healing can lead to chronic wounds. In chronic wounds, inflammatory phase keeps continuing, therefore proliferative phase is prolonged. To treat chronic wounds, causes of constant inflammation must be addressed and treated accordingly.
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