What Happens During the Stages of Wound Healing?

A wound, basically, is an opening or a cut in the skin. It could be a mere scratch, or a very small cut, as small as a paper cut.

A wound result from different causes, such as an accident, a trauma, or a fall. A person might get a cut during surgery – technically, that’s also a wound. Wounds are patched up by the body through a complex process. And the process of wound healing itself is handled by a complex system. Each of the stages of wound healing plays a very important role in the healing process. Wound healing requires the coming together of many parts and steps.

stages of wound healing
Photo Credit: ResearchGate

What are the different stages of wound healing?

There are four stages of wound healing. These include:

  • Preventing excessive loss of blood
  • Cleaning and guarding the area against infections
  • Repair and healing
  • Maturation

The repair process can be facilitated by cleaning up the wound and covering it.

Preventing excessive loss of blood: Hemostasis

When you sustain an injury, your skin or the injured part starts bleeding. So, the first stage of wound healing involves stopping the flow of blood. This process is known as hemostasis.

Hemostasis or blood clotting starts just a few seconds to minutes after you’ve sustained an injury. This clot can be described as the “good blood clot” because it prevents the loss of excess blood. Clotting helps to close off the wound as well as start the healing process, thus creating a scab.

Scabbing (clotting)

There are three phases involved in clotting:

  1. Narrowing of blood vessels around the injury. This helps to seal the injury and stop bleeding.
  2. Clumping together of platelets to create a “plug” in the wound.
  3. A protein known as fibrin is involved in the coagulation process. Fibrin is also known as “blood glue.” It creates a netting that holds the platelet plug together. And so, there’s now a scab over the wound.
  4. Inflammation, which takes charge of wound cleansing and healing.

Once the bleeding stops, your body can start cleaning the wound and healing it.

First, there will be a slight opening of the blood vessels around the wound to allow the free flow of blood into it.

The flow of blood will cause slight reddening and swelling of the injured area. The area might also feel slightly warm. But not to worry, it is an indication that help is on the way.

Blood is a carrier of nutrients and oxygen. So, a fresh supply of blood to the wound means that nutrients and oxygen is being supplied to the wound to facilitate its healing. Macrophages (a kind of white blood cell) also arrive at the site of the injury.

Macrophages contribute to wound cleaning and healing by fighting infections. They also release chemical messengers known as growth factors to facilitate repair of the affected area.

If you look closely at this time, you may see some clear fluid around the injured area. This is an indication that white blood cells are at work to defend and rebuild the area.

Rebuilding: proliferative & growth phase

After cleaning and stabilizing the wound, the body can begin the rebuilding process. Red blood cells are attracted to the site. Upon arrival, they begin creating new tissues. The inured site is now similar to a construction site, only that the body creates its own building materials.

Chemical signals inform body cells to create collagen – elastic tissues. The collagen facilitates the repair of wounded tissues. Collagen is just like a scaffold upon which other cells can be built.

During this stage, one might notice a fresh, red scar. The scar fades slowly and has a flattened appearance.

Maturation phase of wound healing

Even if your wound looks like it’s been closed and repaired, the healing process is still ongoing inside. It might look stretched, puckered, or pink. You may even feel some tightness or itchiness over the affected area.

How long does it take for a wound to heal?

The duration taken for a wound to heal depends on the depth of the cut. Sometimes, complete healing of a wound might take as long as a few years. Healing of an open wound takes longer than a closed wound.

A study by Johns Hopkins Medicine shows that most wounds are repaired within a timeframe of three months. The new tissue and skin are about 80% the strength of the former tissue (prior to injury), as reported by the University of Rochester Medical Centre.

A deep or large cut heals faster if sutured. This reduces the size of the area that your body has to rebuild.

This explains why surgical wounds heal faster compared to other kinds of wounds. A surgical wound heals in about 6 – 8 weeks, as reported by St. Joseph’s Healthcare Hamilton.

Wounds also heal better and faster if they are covered. Also, moisture is important for wound healing, according to the Cleveland Clinic. Using a bandage also helps the wound to stay clean.

Certain health conditions can impede the process of wound healing. This may happen even if the cut is due to a medical procedure or surgery.

Poor healing of wounds

Blood supply is a major factor that contributes to wound healing.

Blood transports nutrients, oxygen, and everything required for wound healing to the site of injury. If a wound does not receive a sufficient supply of blood, its healing time will be prolonged.

What are the risk factors for poor wound healing?

At least 6.5 million Americans have poorly healed wounds. Several factors may contribute to poor healing of wounds. For one, a person’s age can affect wound healing. People who are old have slower healing wounds compared to younger people.

Certain health conditions can impede the proper flow of blood. These conditions affect wound healing. They include:

  • Obesity
  • Diabetes
  • Vascular disease
  • High blood pressure

A chronic wound doesn’t heal fast. It heals slowly. It is important that you see a doctor if you sustain a chronic injury.

How can I treat slow-healing wounds?

There are several treatments for poorly-healed wounds. They include:

  • Medications to improve blood flow
  • Therapy to minimize swelling
  • Wound debridement, or removal of dead tissues from the wound to facilitate healing
  • Skin ointments to help the healing process
  • Bandages and other coverings to speed up the healing process

How do I know that my wound is infected?

The infection causes a wound to heal slowly. This happens because your body is hard at work cleaning up and protecting the wound, and so cannot move fast to the rebuilding stage.

A wound gets infected when fungi, bacteria, and other microbes penetrate a wound before it is fully healed. Signs that a wound has been infected include:

  • Slow healing of a wound
  • Redness
  • Swelling
  • Oozing liquid or pus
  • Warm or hot to touch
  • Tenderness or pain
  • Redness

An infected wound can be treated by:

  • Having the wound cleaned
  • Antibiotic medications
  • Removal of damaged or dead tissue around the wound
  • Skin ointments (with antibiotic properties)