Wound Healing Lecture Notes

Phases of Wound Healing

• Hemostasis:
  • Goal: Stop bleeding
  • Involves: Vasoconstriction, clotting cascade, platelet activation
• Inflammatory Stage:
  • Normal part of healing
  • Neutrophils (first responders) arrive at injury
  • Process: Diapedesis via leaky capillaries causing swelling, edema, and pain
• Proliferation Phase:
  • Generating new skin cells
  • Fills and covers the wound
• Maturation Phase:
  • Remodeling scar tissue
  • Might take a year or more to rebuild collagen

Healing by Intention

• Primary Intention:
  • Edges of the wound are well approximated
  • Examples: Surgical incisions, paper cuts
• Secondary Intention:
  • Wound left open to heal from inside out
  • Involves: Granulation, contraction, epithelialization
  • Higher risk of infection, longer healing time
  • Example: Pressure injury
• Tertiary Intention:
  • Delayed closure of a wound
  • Allows observation, irrigation, debridement
  • Closed surgically when infection risk is lower

Complications and Barriers to Healing

• Dehiscence:
  • Closed wound reopens
• Evisceration:
  • Dehiscence with organs protruding
  • Medical emergency requiring immediate intervention
  • Actions: Saline-moistened gauze, lower head of bed, notify provider
• Barriers:
  • Chronic illnesses (e.g., diabetes mellitus)
  • Poor circulation
  • Immunosuppression (e.g., corticosteroid use)

Drainage and Wound Appearance

• Types of Drainage:

  • Serous: Watery, clear or slightly off-white
  • Serosanguineous: Serous fluid mixed with blood
  • Sanguineous: Bright red, bloody
  • Purulent: Pus-like, thick, cloudy, malodorous

• Wound Appearance:

  • Red: Healthy, good circulation
  • Yellow: Needs cleaning
  • Black: Requires debridement

Conclusion

• Important to monitor wound healing process and be aware of complications
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Note: Ensure proper understanding of wound healing phases and complications for nursing practice.