We all experience a type of wound healing in our life. Whether it be from a fall off a bike, trip, scuff against a wall or surgery we can experience stages of wound healing. The stages of wound healing proceed in an organized way and follow four processes: hemostasis, inflammation, proliferation and maturation. Although the stages of wound healing are linear, wounds can progress backward or forward depending on internal and external patient conditions.
An 80 year old male presents with resolving decubitus, that are now oozing and red. The wound team has been involved. His daughter wants information regarding his skin condition.
Describe the phases of wound healing.
After you cut, scrap, or puncture your skin you start bleeding. Within seconds blood starts to clump together and a clot forms This stops the bleeding. These clots will turn into scabs. Then inflammation starts once the wound is clotted. “Blood vessels can open a bit to allow fresh nutrients and oxygen into the wound for healing. Blood-borne oxygen is essential for healing. The right balance of oxygen is also important — too much or too little and the wound won’t heal correctly. Another type of blood cell, a white blood cell called a macrophage, takes on the role of wound protector. This cell fights infection and oversees the repair process” (How wounds heal. Johns Hopkins Medicine. (2021).). Growth and rebuilding, oxygen rich red blood cells arrive to help build tissue. Chemicals signal to create collagen for repair reprocess. Strengthening, over time new tissue gets stronger. Stretching and itching may occur. This phase may take 3 months depending on wound type.
What is resolution, regeneration, and replacement?
After removal of cellular debris, any necrotic parenchymal cells may be replaced by new parenchymal cells of the same type in a process known as regeneration. When resolution and regeneration are not possible, necrotic cells are replaced with collagen; this is termed organization, or repair by scar formation.
What is the significance of the oozing and discoloration?
Stages of healing and expelling bacteria from wound.
What factors impede the healing process and why?
Nutrition, health problems, microbes in wound, obesity, repeated trauma, and age. The physiology of wound healing and factors that impede wound repair are discussed. Those factors commonly seen in critical illness include advanced age, diabetes mellitus, compromised immunocompetence, inadequate perfusion, and oxygenation, infection, malnutrition, obesity, and preoperative illness. Knowledge of management of the physiologic factors that affect wound healing enables the nurse to maximize tissue repair and prevent wound complications (NA;, N. S. O. P. B. S., n.d.).
Reference
How wounds heal. Johns Hopkins Medicine. (2021). https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/how-wounds-heal.
NA;, N. S. O. P. B. S. (n.d.). Physiology of wound healing and risk factors that impede the healing process. AACN clinical issues in critical care nursing. https://pubmed.ncbi.nlm.nih.