The Four Stages of Wound Healing
Wound healing commonly goes through four distinct linear stages: hemostasis, inflammation, proliferation and maturation. However, in some cases, wounds can regress and advance according to the internal and external health of the patient.
Here are the four stages of wound healing in more detail:
1: Hemostasis Phase
Hemostasis is the name given to the process of the wound closing through blood clotting. A fresh wound will leak blood from the injury site, and the first step of hemostasis occurs when blood vessels contract to restrict blood flow.
In the next step, platelets in the blood stick together to form a seal over the wall of the blood vessel to stop blood loss. Finally, blood coagulation strengthens and supports the platelet plug with fibrin threads, a molecular binding agent.
This first stage of hemostasis wound healing happens fast, usually within seconds of the trauma. The second stage involving the first fibrin strands begins to adhere in around sixty seconds. The last step of hemostasis consists of forming a thrombus or clot through coagulation that occurs immediately after this.
2: Inflammatory Phase
The second stage of wound healing involves the inflammation of the wound area, which begins right after the injury when the trauma causes damage to the blood vessels. The injured blood vessels leak a substance called transudate, a fluid made from water, salt and protein.
The fluid release and build-up cause swelling at the wound site. Inflammation acts to both control bleeding and prevents infection of the wound. The transudate fluid inflammation engorges the injury allowing the body to heal and repair damaged cells at the site of the wound and remove damaged cells, pathogens, and bacteria.
3: Proliferative Phase
This stage of wound healing is when the body rebuilds the area with new tissues made from collagen and extracellular matrix. As part of the repair stage, a new network of blood vessels is created to carry sufficient nutrients and oxygen to the area.
Myofibroblasts act to contract the wound edges, knitting the wound closed. During a healthy proliferation phase, new granulation tissue is laid down and can be identified for its pink coloour and uneven texture. In the final stage of this phase, epithelial cells act to resurface the injury, which happens faster when the wound is kept moist and hydrated.
4: Maturation Phase
This final wound healing stage is also known as the remodelling stage. This is when the wound fully closes, and the cells used to repair the damage, but are no longer needed, are removed by apoptosis. The collagen laid down during the proliferation phase is aligned along tension lines. Water is reabsorbed into the tissues to allow new collagen fibres to lie together and cross-link, reducing scar tissue thickness and strengthening the wound area.
Are you a healthcare practitioner who deals with patient wound care?
PDUK offers a comprehensive online course called The ABC of wound care for health care assistants. This is an ideal course for health care assistants that deal with wound care in their clinical practice or medical setting.
The course will update your knowledge of the most up-to-date wound care management treatment options and management plans. This course will update your skills and boost your confidence when helping patients with their wound care and recovery for new health care assistants or those returning to the profession after a period of absence.
You may be interested in our Guide to complex wound care
for nurse practitioners, ward-based nurses, practice nurses, community nurses, and allied health professionals. This online course will help you better assess and manage more complicated wounds that prove more challenging than are encountered in standard wound care plans.
Infected wounds can also present more challenges for medical teams. PDUK offers a course called Acute wound management for urgent & primary care practitioners, which includes treatment for infection.
This is a face-to-face workshop for junior doctors, nurse practitioners, ENPs, practice nurses, school nurses, paramedics and allied health professionals tasked with assessing and treating acute wounds and infections.
The workshop will allow you to gain knowledge and experience in suturing and other wound closure techniques and managing burns and infected wound presentations.