Types of Healing

Study Notes

Primary intention: Healing occurs directly, with minimal scar formation, and is often seen in clean, surgical wounds with minimal tissue loss.
Secondary intention: Healing occurs indirectly, with significant scar formation, and is often seen in contaminated or infected wounds, or those with significant tissue loss.
Tertiary intention: Healing occurs indirectly, with delayed primary closure, and is often seen in wounds that are initially left open due to contamination or infection.

Inflammation:
- Occurs immediately after injury
- Characterized by increased blood flow, swelling, and pain
- Neutrophils and macrophages remove debris and bacteria
Debridement:
- Occurs 2-5 days after injury
- Characterized by removal of dead tissue and debris
- Macrophages and proteolytic enzymes break down dead tissue
Proliferation:
- Occurs 5-14 days after injury
- Characterized by rapid cell growth and tissue formation
- Fibroblasts produce collagen, and blood vessels form
Remodeling:
- Occurs 2-6 weeks after injury
- Characterized by maturation and strengthening of new tissue
- Collagen is reorganized, and scar tissue is refined

Age: Healing slows with age
Nutrition: Malnutrition impairs healing
Oxygenation: Hypoxia impairs healing
Infection: Impairs healing by increasing inflammation and tissue damage
Hormones: Hormonal imbalance can impair healing
Medications: Certain medications, such as corticosteroids, can impair healing

Growth factors: Promote cell growth and differentiation
Cytokines: Regulate inflammation and immune response
Chemokines: Attract immune cells to site of injury
Extracellular matrix: Provides structure and support for new tissue formation

Chronic wounds: Wounds that fail to heal within a normal timeframe
Wound stagnation: Wounds that fail to progress through the healing phases
Wound infection: Infection that impairs healing
Systemic diseases: Diabetes, atherosclerosis, and other systemic diseases can impair healing

Healing can occur through primary intention, resulting in minimal scar formation, often seen in clean, surgical wounds with minimal tissue loss.
Secondary intention healing occurs indirectly, with significant scar formation, often seen in contaminated or infected wounds, or those with significant tissue loss.
Tertiary intention healing occurs indirectly, with delayed primary closure, often seen in wounds that are initially left open due to contamination or infection.

Occurs immediately after injury, characterized by increased blood flow, swelling, and pain.
Neutrophils and macrophages remove debris and bacteria during this phase.

Occurs 2-5 days after injury, characterized by removal of dead tissue and debris.
Macrophages and proteolytic enzymes break down dead tissue during this phase.

Occurs 5-14 days after injury, characterized by rapid cell growth and tissue formation.
Fibroblasts produce collagen, and blood vessels form during this phase.

Occurs 2-6 weeks after injury, characterized by maturation and strengthening of new tissue.
Collagen is reorganized, and scar tissue is refined during this phase.

Growth factors promote cell growth and differentiation.
Cytokines regulate inflammation and immune response.
Chemokines attract immune cells to the site of injury.
The extracellular matrix provides structure and support for new tissue formation.

Chronic wounds are wounds that fail to heal within a normal timeframe.
Wound stagnation occurs when wounds fail to progress through the healing phases.
Wound infection impairs healing by increasing inflammation and tissue damage.
Systemic diseases, such as diabetes and atherosclerosis, can impair healing.