Types And Stages Of Wound Healing

Every injury goes through various stages of healing which is dependent on the type of injury and the severity of it. Here we talk about the types and stages of wound healing that can help you understand how best to care for a wound.

Types Of Wound Healing

1. Primary Intention Wound Healing : Primary intention wound healing or simply primary wound healing refers to the process in which a wound of closed by a doctor using staples, stitches, glue or other wound-closing processes. Closing a wound in such a way reduces the number of tissue lost and enables the body to focus on healing a rather smaller area. It helps the wound heal faster.

   For example, if you have a big cut on your body, the body will take several weeks to heal the cut by filling up the gap caused by the cut. But if the edges of the cut are manually brought together and stitched or glued, it’ll take only a few days for the body to heal the scar.

2. Secondary Intention Wound healing : Secondary wound healing, also called full-thickness healing, is the process in which the wound is difficult to stitch as the sides of the wound are not opposed and the healing must occur from the bottom making its way up. In such cases, doctors may leave the wound to heal naturally.

   This type of healing completely depends on the body’s natural healing mechanisms. It may take longer than primary wound healing, depending on the wound size. The risks of infection and contamination in high in such cases as the wound is exposed to the external environment. Therefore, it is essential to keep these wounds clean to prevent infections.

3. Tertiary Intention Wound Healing : Tertiary wound healing generally follows a delayed process of primary wound closure. If the doctor is uncertain about the possibility of trapping infectious germs by closing the wound right away, they may leave the wound open for some time. In such cases, the wound is allowed to granulate or doctors may wait for the other procedures/therapies to complete before closing the wound.

Stages Of Wound Healing :

All wounds go through four stages of healing, ranging from initial wound reaction to the later stages of creating new skin. Here are the four stages of wound healing.

1. Hemostasis Phase (Stage 1) : Hemostasis is the first response from the body after the injury happens. The wound causes blood and other bodily fluids to leave the body and the body’s first response is to stop the blood flow. Platelets and thrombocytes in the blood begin to accumulate near the open wound thickening the blood and forming a clot to restrict bleeding. This clot also prevents germs from entering the body via the wound. The platelets release certain chemicals that indicate the onset of the next process and begin the healing process.
2. Inflammatory Phase (Stage 2) : The inflammation phase is where the cleaning and healing of the wounded region begins. After a wound or a trauma, there is some inflammation around the affected region as the immune cells rush to the damaged tissue, and WBCs enter the region to clean the wound from within and move any waste from the site.
3. Proliferative Phase (Stage 3) : In the third stage of wound healing, the body focuses on closing the wound, creating new tissues, and repairing the damages caused to any blood vessels in the affected region.

   The phase has four different sub-processes namely:

   • Epithelialization: The process of creating new skin tissues in the damaged skin.
   • Angiogenesis: The process of creation of new blood vessels.
   • Collagen formation: The process of building up strength in the tissue of the wounded region.
   • Contraction: The process of reduction and eventually closing the wounded region.
4. Maturation Phase (Stage 4) : The maturation or remodeling phase indicated the internal wound healing. The process then switches to creating strong skin to replace the temporary tissue in the wounded area.

Dr Kalyan Chakravarthy

Consultant Plastic Surgeon

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