Healing Process
- The final phase of the inflammation process is healing
- Healing includes two major components:
- Regeneration
- Replacement of lost cells and tissues with cells of the same type
- Repair
- Occurs by primary, secondary, or tertiary intention
- Primary intention – When wound margins are neatly approximated, as in a surgical incision or a paper cut
- Secondary intention – From trauma, ulceration, and infection have large amounts of exudate and wide, irregular wound margins with extensive tissue loss
- Tertiary intention (delayed primary intention) – Contaminated wound is left open and sutured closed after the infection is controlled, and when a primary wound becomes infected, is opened, is allowed to granulate, and is then sutured
- Occurs by primary, secondary, or tertiary intention
- Regeneration
Complications of wound healing
- Adhesions
- Bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together
- Contractions
- Excessive fibrous tissue formation due to shortened muscle tissue
- Dehiscence
- When a surgical incision reopens, either internally or externally, or when a primary healing site bursts open
- Evisceration
- When wound edges separate to the extent that intestines protrude through wound
- Hypertrophic scars
- Overabundance of collagen is produced during healing that results in large, raised red and hard scars
- Keloid formation
- Extra scar tissue grows, forming smooth, hard growths without any tendency to subside
- Hemorrhage
- Abnormal internal or external blood loss caused by suture failure, clotting abnormalities, dislodged clot, infection, or erosion of a blood vessel by a foreign object (tubing, or drains) or infection process