O SlideShare utiliza cookies para otimizar a funcionalidade e o desempenho do site, assim como para apresentar publicidade mais relevante aos nossos usuários. Se você continuar a navegar o site, você aceita o uso de cookies. Leia nosso Contrato do Usuário e nossa Política de Privacidade.
O SlideShare utiliza cookies para otimizar a funcionalidade e o desempenho do site, assim como para apresentar publicidade mais relevante aos nossos usuários. Se você continuar a utilizar o site, você aceita o uso de cookies. Leia nossa Política de Privacidade e nosso Contrato do Usuário para obter mais detalhes.
A Scribd passará a dirigir o SlideShare em 1 de dezembro de 2020A partir desta data, a Scribd passará a gerenciar sua conta do SlideShare e qualquer conteúdo que você possa ter na plataforma. Além disso, serão aplicados os Termos gerais de uso e a Política de Privacidade da Scribd. Se prefira sair da plataforma, por favor, encerre sua conta do SlideShare. Saiba mais.
- is a type of physical trauma wherein the
skin is torn, cut or punctured (open
wound), or where blunt force trauma
causes a contusion (closed wound).
- a break in the continuity of any bodily
tissue due to violence is understood to
encompass any action of external
agency, including for example surgery.
- act or process of curing or restoring the
- prevents the egress of irritants may
result in continued tissue disruption
- comprises a fundamental biological
activity that involves both regenerative
and reparative activities.
- functions to restore the disrupted or
dead tissues to its normal state.
* An ideal repair can be achieved in
tissues undergoing constant renewal
but is least effective in nerve &
* Nerve undergo repair only when cell
bodies are intact.
* Muscle tissue is repaired by fibrous
connective (scar) tissue, with
permanent loss of function.
TYPES OF WOUND HEALING:
1. PRIMARY UNION
- healing by first intention
- there is narrow space between the
two cut surfaces of a wound
- healing is completed in 2-3 weeks
2. SECONDARY UNION
- healing by second intention
- the two cut surfaces cannot be
- granulation tissue tend to heal the
wound from the base of wound
3. DELAYED UNION
- there is movement between the two
- poor blood supply
- pathogenic fractures
Factors Affecting Wound Healing:
1. Infection – promotes further
inflammation & tissue destruction.
2. Foreign Bodies – stimulates
inflammation, thereby impending
the process of healing.
3. Old Age – due to nutritional &
vascular deficiencies and
deteriorating immune system.
4. Nutritional Status – Vitamin C
deficiency has been associated
with impaired healing
5. Concurrent Disease:
a. Vascular Disease – any disturbance
to the blood supply of a tissue
will result in delayed or impaired
b. Diabetes Mellitus – impaired blood
supply, impaired PMN
leukocytes function &
increased susceptibility to
c. Uremia – because of disturbance
in inflammation response.
d. Blood Disease – hemorrhage at
the site of tissue damage,
resulting in large hematomas
that predispose secondary
- Narrow space
between the 2 cut
hemorrhage prior to
- Large gap between
the 2 cut surfaces
that cannot be
- Initial degree of
by blood clot
- Margins of wound
- Mild short-lived acute
reactions occur in the
wound margins at the
- After approximately 24
hours, capillary blood
vessels from wound
margins begin to bud
into the wound space
& then are followed
by both macrophages
- Granulation tissue
to move into the
wound base & sides.
plasma cells &
- Macrophages are
with phagocytosis of
the wound debris &
- Component cells
ensure the removal
of tissue debris,
these cells include
- Fibroblasts begin to
- Fibrous tissue is laid
down in the deeper
layers of the wound.
tends to heal the
wound from the base.
- At the same time or a
little earlier, epithelial
cells from wound
mitosis & migrate
toward center of
forming a complete
but thin epithelial
- Wound undergoes
activity. Thus edges
of the wound is
closed by granulation
tissue & wound
migration & mitosis.
- Epithelium undergoes
maturation to regain
its full thickness.
- Excessive granulation
is formed so that
wound may appear
proud of the adjacent
resolved in a few
- Healing is usually
complete by 2-3
- A longer period may
be required before
there is complete
restoration of the
- Complex interactions
CT formation – initially is essential
for the restoration of normal
ET – subsequently may be
responsible for the formation of
connective tissue scar growth.
Secondary Healing differs from Primary
Healing in several aspects:
1. Large tissue defects initially have
more fibrin & more necrotic debris &
exudates that must be removed.
Inflammation reaction is more
2. Much larger amount of granulation
tissue is formed.
3. Phenomenon of wound contraction.
That is, the defect is markedly
reduced from its original size.