Wound healing process
Wound healing is a physiological response initiated by a disruption in tissue integrity and is imperative in maintaining homeostasis. It is a dynamic and complex process consisting of four partly overlapping phases, namely the inflammatory, migratory, proliferative and maturation phase. Notably, this process is non-linear wherein it can advance and retract through the phases depending on various factors within the patients.
Inflammatory phase
Inflammatory phase can be further divided into hemostasis and inflammation, which is triggered immediately and last for about two to five days succeeding injury.
Hemostasis
Hemostasis is the process which halts bleeding after an injury. During hemostasis, the initial wound stimulates vasoconstriction in the wound bed to diminish blood loss while the exposure of collagen from the wound site causes the activation, aggregation and adhesion of circulating platelets to the damaged endothelium. This results in the degranulation of the adhered platelets that eventually formed the platelet plug via a positive feedback mechanism. Next, coagulation occurs where various factors secreted by damaged tissues and activated platelets activate prothrombin activator that catalyse the conversion of prothrombin to
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During this phase, fibroblasts propagate at the wound and form the new, provisional extracellular matrix by excreting and depositing collagen in random fashion (fibroplasia). Angiogenesis is critical for sustaining the proliferation of fibroblasts. On a similar note, there is also continued growth of blood vessels. Concurrently, epithelization occurs where there is an extensive growth of epithelial cells beneath the scab which cross over the new matrix and covers the granulation tissues. Lastly, the wound contracts and the unused cells undergo