Wound Healing Overview

Overview

This lecture covers the phases of wound healing, types of wound healing by intention, complications and barriers to healing, and normal vs. abnormal wound drainage and appearance.

Phases of Wound Healing

• Hemostasis is the initial phase, aiming to stop bleeding through vasoconstriction and clot formation.
• Inflammatory phase follows; neutrophils arrive via leaky capillaries to prevent infection and cause swelling.
• Proliferation phase is when new skin cells are generated to fill and cover the wound.
• Maturation phase involves remodeling scar tissue, which can take a year or more.

Types of Healing by Intention

• Primary intention: wound edges are well approximated, typical for surgical incisions and small cuts, heals quickly.
• Secondary intention: wound left open, heals from inside out by granulation, contraction, and epithelialization, higher infection risk, longer healing time.
• Tertiary intention: closure of wound is intentionally delayed (to allow observation or cleaning), then closed surgically when infection risk decreases.

Complications and Barriers to Healing

• Dehiscence: previously closed wound reopens.
• Evisceration: dehiscence where internal organs protrude, medical emergency—cover with saline-moistened gauze, lower bed, notify provider.
• Barriers include chronic illness (especially diabetes), poor circulation, poor glycemic control, and immunosuppression (e.g., corticosteroids).

Wound Drainage and Appearance

• Serous drainage: clear, watery, normal.
• Serosanguineous: pink-tinged (serous mixed with blood), normal.
• Sanguineous: bright red, bloody drainage.
• Purulent: thick, cloudy, white/yellow/beige with foul odor, indicates infection.
• Red, beefy wound: healthy, good circulation.
• Yellow wound: needs cleaning.
• Black wound: requires debridement due to dead tissue.

Key Terms & Definitions

• Hemostasis — stopping bleeding via vasoconstriction and clotting.
• Diapedesis — process where neutrophils move through leaky capillaries to site of injury.
• Dehiscence — reopening of a previously closed wound.
• Evisceration — organs protruding from an open wound.
• Granulation — new tissue formation during healing.
• Debridement — removal of dead tissue from a wound.

Action Items / Next Steps

• Review wound types and phases of healing.
• Learn proper wound emergency procedures (e.g., care for evisceration).
• Prepare for next lecture on diabetic foot care and wound care.

Certainly! The term "serosanguineous" refers to a type of wound drainage (exudate) that is a mixture of serous fluid and blood.

• Serous fluid is clear, watery, and pale yellow or slightly off-white.
• When some blood mixes with this clear fluid, it gives the drainage a pink-tinged appearance.

So, a wound with pink-tinged drainage is showing serosanguineous exudate because the pink color comes from the combination of clear fluid and a small amount of blood.

This differs from:

• Serous drainage, which is clear or watery without blood.
• Sanguineous drainage, which is bright red and mostly blood.
• Purulent drainage, which is thick, cloudy, and often yellow or green, indicating infection.

In summary:

Therefore, serosanguineous is the correct answer for pink-tinged drainage.