Every phase of the wound healing process has specific treatment needs.
A properly healing wound goes through three main wound healing phases: inflammation, proliferation, and maturation. Each of these phases needs to be treated differently to encourage a healthy transition into recovery. While the inflammation phase focuses on cleaning and preparing the wound for the rest of the healing process, the proliferation phase rebuilds the damaged areas within the wound. There are three overlapping wound healing stages within the proliferation phase, during which proper wound care is necessary to create optimal conditions for successful wound healing.
Proliferation Phase 1: Granulation
Granulation, the first step of the proliferation wound healing phases, begins rebuilding the damaged areas of the wound with the production of granulation tissues. These tissues contain collagen proteins generated by fibroblasts, resulting in the development of a supporting network of connective tissue. Ground substance, an extracellular gel-like material, is also present to fill in any gaps between cells. They also contain interstitial fluids that surround the cells and provide nutrients. This stage essentially involves building a framework within the wound area so that it can heal.
Collagen dressings can be used to assist in the process of collagen production, especially for wounds that are healing slowly at this stage. You can use these dressings for large, open cuts because they increase fibroblast movement, which leads to faster wound repair.
Proliferation Phase 2: Angiogenesis and Contraction
Angiogenesis is the process of rebuilding blood vessels within the wound. Thanks to the collagen and extracellular matrix areas created during the granulation stage, new blood vessels are now able to grow during this stage. Angiogenesis is triggered by macrophages, the white blood cells that are formed by the immune system after an injury occurs. Macrophages work to protect cells from infection and stimulate the rebuilding of blood vessels.
Allowing oxygen into the wound is very important at this stage. Wound contraction begins once the connective tissues within the wound have been repaired, and the body is ready for the wound to be closed up. Fibroblasts develop around the edges of the open wound and begin to contract, pulling the skin closed.
Breathable Wound Dressings
Allowing oxygen to reach a wound is beneficial for healing during this stage, so choosing to use a bandage or not using one is an important consideration. To protect wounds from further damage, irritation, or dirt, apply a breathable bandage. Using gauze will also help keep the wound covered while allowing oxygen to pass through.
Proliferation Phase 3: Re-Epithelialization
Re-epithelialization is the final step of the proliferation wound healing phases. Epithelial cells return to resurface the wound and complete the sealing process of the affected area. During this stage, moisture is essential in assisting cells to move more easily beneath scar tissue. Without a moist healing environment, scabs become hard and epithelial cells struggle to migrate easily underneath the necrotic cells, possibly leading to permanent scarring.
After the proliferation wound healing phases are complete, the wound enters the maturation stage, which can last months or even years.
During the final stage of the proliferation process, hydrogel dressings can be used to keep your wound hydrated and protect it from infection. Using hydrogel dressings during the re-epithelization period will keep scar tissues moist, supporting epithelial cell movement.
Advanced Tissue has an extensive selection of advanced wound care products for a physician to select from when working with patients. As a way to help clinicians, our Wound Treatment Product Guide can be downloaded for easy reference.