Wound healing

Hand abrasion

Initial injury	3 days	17 days	30 days

Wound healing refers to a living organism's replacement of destroyed or damaged tissue by newly produced tissue.^[1]

In undamaged skin, the epidermis (surface, epithelial layer) and dermis (deeper, connective layer) form a protective barrier against the external environment. When the barrier is broken, a regulated sequence of biochemical events is set into motion to repair the damage.^[1]^[2] This process is divided into predictable phases: blood clotting (hemostasis), inflammation, tissue growth (cell proliferation), and tissue remodeling (maturation and cell differentiation). Blood clotting may be considered to be part of the inflammation stage instead of a separate stage.^[3]

The wound-healing process is not only complex but fragile, and it is susceptible to interruption or failure leading to the formation of non-healing chronic wounds. Factors that contribute to non-healing chronic wounds are diabetes, venous or arterial disease, infection, and metabolic deficiencies of old age.^[4]

Wound care encourages and speeds wound healing via cleaning and protection from reinjury or infection. Depending on each patient's needs, it can range from the simplest first aid to entire nursing specialties such as wound, ostomy, and continence nursing and burn center care.

^ ^a ^b Nguyen DT, Orgill DP, Murphy GT (2009). "4 The Pathophysiologic Basis for Wound Healing and Cutaneous Regeneration". In Orgill DP, Blanco C (eds.). Biomaterials for Treating Skin Loss. Elsevier. pp. 25–57. ISBN 978-1-84569-554-5.
^ Rieger S, Zhao H, Martin P, Abe K, Lisse TS (January 2015). "The role of nuclear hormone receptors in cutaneous wound repair". Cell Biochemistry and Function. 33 (1): 1–13. doi:10.1002/cbf.3086. PMC 4357276. PMID 25529612.
^ Stadelmann WK, Digenis AG, Tobin GR (August 1998). "Physiology and healing dynamics of chronic cutaneous wounds". American Journal of Surgery. 176 (2A Suppl): 26S–38S. doi:10.1016/S0002-9610(98)00183-4. PMID 9777970.
^ Enoch, S. Price, P. (2004). Cellular, molecular and biochemical differences in the pathophysiology of healing between acute wounds, chronic wounds and wounds in the elderly Archived 2017-07-06 at the Wayback Machine.

[Dinh_Nguyen,_Dennis_Orgill,_George_Murphy-1] Nguyen DT, Orgill DP, Murphy GT (2009). "4 The Pathophysiologic Basis for Wound Healing and Cutaneous Regeneration". In Orgill DP, Blanco C (eds.). Biomaterials for Treating Skin Loss. Elsevier. pp. 25–57. ISBN 978-1-84569-554-5.

[Rieger-2] Rieger S, Zhao H, Martin P, Abe K, Lisse TS (January 2015). "The role of nuclear hormone receptors in cutaneous wound repair". Cell Biochemistry and Function. 33 (1): 1–13. doi:10.1002/cbf.3086. PMC 4357276. PMID 25529612.

[Stadelmann-3] Stadelmann WK, Digenis AG, Tobin GR (August 1998). "Physiology and healing dynamics of chronic cutaneous wounds". American Journal of Surgery. 176 (2A Suppl): 26S–38S. doi:10.1016/S0002-9610(98)00183-4. PMID 9777970.

[Enoch-4] Enoch, S. Price, P. (2004). Cellular, molecular and biochemical differences in the pathophysiology of healing between acute wounds, chronic wounds and wounds in the elderly Archived 2017-07-06 at the Wayback Machine.

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