Evidence-based Wound Management As clinicians, we know that patients do not always act in their own best interest. They may cling to old remedies based on tradition or folklore, rather than researching current and accepted treatments. An example of this is applying butter to burn wounds. As practitioners we know that this is not an…
In addition to local factors that can influence wound healing, such as circulation, sensation and mechanical stress, there are a number of systemic factors that can also play a role. Aging– aging causes many changes that adversely affect the skin and its ability to heal and regenerate itself. In terms of ability to heal, as we…
There are several local factors that can affect wound healing. Circulation, sensation and mechanical stress are among the most common local factors that have a bearing on healing. Circulation Palpable pulses do not always indicate sufficient circulation. They indicate that the major vessels have good flow, but they do not indicate that the microcirculation is…
We’ve already discussed problems with wound healing that occur during the inflammatory and proliferative phases of wound healing. Next we’ll take a look at what can go wrong during the maturation and remodeling stage of wound healing. Hypertrophic Scarring Hypertrophic scarring occurs when there is an overproduction of immature collagen during the maturation phase of…
In part one of this series, we discussed abnormal wound healing in terms of too much or too little inflammation (absence of inflammation versus chronic inflammation). The inflammatory phase is not the only phase of healing in which healing can be derailed- it can also happen in the proliferative phase, where granulation takes place. Hypogranulation…
Although we often think of the inflammatory process as something undesirable, inflammation as a process is vital to wound healing. Wounds generally progress through the phases of wound healing in an orderly fashion, but sometimes one of the phases of wound healing is altered or interrupted by internal or external factors, leading to abnormal wound…
The wound microenvironment is populated with a variety of cells and chemicals that assist in wound healing. Understanding what these substances do and how they contribute to healing is important to gaining an advanced understanding of wound healing and management. Let’s look at these cells and chemicals in greater detail. Cells – Wound Microenvironment Cells…
There are three types of wound closure: primary, secondary and delayed primary closure. Let’s look at each of them in a little more detail. Primary wound closure Primary closure (sometimes referred to as healing by primary intention) is the fastest type of wound closure. A good example of primary closure is a paper cut. You…
As you might remember from part 1 of this series, there are three phases of wound healing. Last week we discussed the inflammatory phase, which lasts for a few days following injury. Now let’s look at the next two phases: the proliferative and maturation/remodeling phases. Proliferative Phase The proliferation phase generally starts within 48 hours…
Wound healing proceeds in a relatively organized fashion, following three processes that overlap- inflammation, proliferation and maturation/remodeling (some sources will describe this process as four phases breaking the inflammation process into hemostasis and inflammation). How much do you remember about the phases of wound healing? First, let’s take a look at the inflammatory phase, which…
