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The three different phases of wound healing

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Wounds occur for a huge range of reasons and come in all shapes, sizes, and severity. But it’s the process by which a wound heals that is most important. Poorly healed wounds can lead to infection and scarring, possibly requiring further surgical intervention.

The healing process itself is highly dynamic and is divided into three phrases. The key thing to remember here is that wounds don’t always follow a linear path as they heal. Some may open up again, some may take longer than expected to heal and some may lead to issues such as keloid scarring. It all depends on factors such as how the wound is cared for and even patient genetics.

The three phases of wound healing are the inflammatory phase, the proliferation phase, and the maturation phase. Here we look more closely at each:

 The inflammatory phase

The wound will naturally begin the inflammatory phase when the body naturally starts to respond to the injury. Immediately after the wound has occurred, blood vessels in the wound bed contract to form a clot. When a clot is present, the blood vessels then dilate to allow essential antibodies, white blood cells, enzymes, growth factors and nutrients to reach the wounded area. This triggers the inflammation of the skin around the injury. The area is likely to be warm to the touch, swollen and painful as the body mounts its defence against infection.

 The proliferation phase

During proliferation, new granulation tissue is formed to help “rebuild” the skin underneath and around the wound. It’s made up of collagen and extracellular matrix, where “angiogenesis” (the creation of new blood vessels) can take place.

Healthy granulation tissue should be slightly uneven and pinkish or reddish in colour. It also shouldn’t bleed. The texture and colour of this tissue gives some important clues about how well the injury is healing. If it is darker in colour, it may be a sign of ischaemia, poor perfusion and/or infection. Epithelial cells finally resurface the wound, a process which is called ‘epithelialisation’.

 The maturation phase

This is the final phase and takes place once the wound is closed. Collagen is remodelled from type III to type I during maturation, and there’s less cellular activity in general. Finally, the number of blood vessels around the injury decreases, with the wound well on the way to full healing.

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If you’re a healthcare professional who is keen to understand more about wounds and wound healing, PDUK’s popular Acute Wound Management course is ideal. Aimed at urgent and primary care practitioners in particular, it’s the chance for you to boost your core knowledge and skills in the assessment and treatment of acute wounds and infections.

Held at Guy’s Hospital in London, this one-day course is worth a valuable 7 hours of CPD. As with all our courses, equipment, course materials, evaluation and certificate of attendance are all provided.

Don’t forget our related online healthcare courses too, held face-to-face and online respectively:

Allowing for flexible, interactive but relaxed learning, places on these courses tend to fill up quickly. With this in mind, we always suggest booking up as early as possible to avoid disappointment. And of course, if you have any questions please feel free to contact us - we’re here to help.