Discussion – Wound Healing
Wound healing is a complex process. The process is characterized by three phases that overlap sequentially. These are; the inflammatory phase, proliferative or granulation phase, and remodeling or maturation phase (Cañedo-Dorantes & Cañedo-Ayala, 2019). The inflammation phase consists of neurogenic cutaneous inflammation followed by homeostasis and neutrophil & monocyte-macrophage accumulation in the wound. In cutaneous neurogenic inflammation, the aim is to stop the damage. Neuropeptides are released to promote vasodilatation and microvascular permeability of blood vessels that encircle the wound resulting in swelling. Platelet homeostasis follows to initiate coagulation and stop the bleeding. Neutrophils, monocytes, and macrophages infiltrate the injury site to clear the wound of cellular debris and eliminate pathogens.
The proliferative or granulation phase is characterized by fibroplasia, reepithelialization, angiogenesis, and peripheral nerve repair. Fibroplasias initiates collagen synthesis and deposition, which initiates wound contraction as granulation tissue grows. Reepithilialization involves basal cell proliferation, which later differentiates into epithelial cells, increasing collagen deposition. Angiogenesis is the growth and differentiation of endothelial cells to form new vascular structures. Peripheral nerve repair consists of two processes: nerve regeneration and collateral reinnervation.
The remodeling and maturation phase involves the restoration of skin integrity. The skeletal muscles, nerves, blood vessels, excess collagen tissue and epidermis are remodeled into functional tissue. The wound gains maximum strength as further contraction occurs with maturation. Consistently, wound resolution is the process of restoring the body tissue to its pre-injury state. Regeneration is the process of closing the wound, often with scarring. Replacement is the remodelling phase when the wound closes completely.
Oozing and discolouration are significant during healing as the body cleans up the wound area of necrotized tissue and pathogens. It may also signify bacterial infection of the wound. Furthermore, it may indicate the existence of a chronic co-morbidity such as diabetes. Subsequently, Factors that impede the healing process include defects in collagen synthesis, hypoxia, infection, ischemia, and systemic chronic conditions like diabetes (Mercandetti, M., 2021). These factors inhibit normal collagen synthesis in the proliferation and maturation phases.
References
Cañedo-Dorantes, L., & Cañedo-Ayala, M. (2019). Skin Acute Wound Healing: A Comprehensive Review. Retrieved 4 May 2021, from https://downloads.hindawi.com/journals/iji/2019/3706315.pdf
Mercandetti, M. (2021). Wound Healing and Repair: Overview, Types of Wound Healing, Categories of Wound Healing. Retrieved 3 May 2021, from https://emedicine.medscape.com/article/1298129-overview
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Discussion – Wound Healing
Discussion Prompt
Part 1: Choose a condition from the following case studies: Myasthenia Gravis, Wound Healing, Osteoarthritis, Fracture (Week 8 Case Study Details). You may work in small groups of up to 3 students if desired.
Week 8 Discussion-Wound Healing
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