Types of Wound Healing

The types of wound healing

1.) Healing by first intention

The primary wound healing or primary closure

Describes the wound closed, the approximation of the margins of the wound or graft or flap investment, or the wounds created and closed in the operating room.

The best choice for the fresh wounds of well vascularized areas

Indications include recent (<24 years), clean wounds, where the viable tissue is free of tension and rapprochement and eversion of skin edges are feasible.

The injury is treated with irrigation and débribement and tissue margins are calculated using simple methods or sutures, grafts or flaps.

The wounds are treated within 24 hours after injury, before the development of granulation tissue.

Final appearance of a scar depends on: his initial injury, the amount of pollution, and ischemia as well as the method and accuracy of the wound, but they are often faster and more aesthetically pleasing to healing.

2). Healing by second intention

secondary healing or spontaneous recovery

Describes an open wound, and allowed to close by epithelialization and contraction.

Commonly used in the treatment of contaminated or infected wounds.

The open wound is healing without surgery.

Indicated in highly contaminated or infected wounds.

Unlike the primary lesion, the approximation of the edges of the wound is re-epithelialization and wound contraction by myofibroblasts.

The presence of granulation tissue.

Late complications are wound contracture and hypertrophic scars

3.) Healing by third intention

tertiary delayed healing or primary closure

Useful for the management of wounds that are too badly contaminated with primary closure, but seems clean and well vascularized after 4-5 days of observation open. During this period, the inflammatory process reduces the concentration of bacteria from the wound to allow secure closure.

Subsequent repair of a wound initially left open or not previously treated.

Indicated for infected wounds or unhealthy with a high content of bacterial, wound with a length of time since the injury, or serious injury with a crushing component with significant devitalized tissue.

Often used in infected wounds, where the number of bacteria, the main obstacle for the closure and the inflammatory process can be left débribe wounds.

Wound edges are approximated within 3-4 days, and the tensile strength developed with primary closure.

4) partial thickness wounds

The wound is superficial, does not penetrate the entire dermis.

Type of healing seen with first-degree burns and abrasions.

Healing occurs mainly by epithelialization fall of skin elements.

Unless the secondary recovery of contraction of full thickness wounds

Low production of collagen and scar tissue formation