3 - Ways of Describing wounds

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Acute wounds

are expected to heal completely within a few days or weeks. The wound is clean, with even edges that are usually closed with sutures or staples. The risk of infection is minimal.

Intentional wounds

are the result of a planned surgical or medical intervention. Examples of intentional wounds are surgical incisions and sites where intravenous (IV) lines and other medical devices are inserted into the body through an artificial sterile opening. Intentional wounds are usually created under controlled conditions. Precautions are taken to minimize the risk of infection. The edges of the wound are usually clean and even, and the wound is usually closed with sutures (stitches) or staples. healing is usually uncomplicated.

Chronic wounds

are delayed in healing or they may never heal completely. These wounds often occur in people who have underlying medical conditions that affect the body's ability wounds on its own, such as cardiovascular disease or diabetes. Three of the most common types of chronic wounds are late-stage pressure ulcers, venous (stasis) ulcers, and arterial ulcers on the lower legs. The edges of these wounds cannot be closed with sutures or staples. The risk of infection is very high.

Arterial Ulcers

Arterial ulcers develop on the feet and lower legs. People who have conditions that affect arterial blood flow (such as arteriosclerosis, diabetes, and hypertension) are at risk for developing arterial ulcers. Because blood flow to the tissues is not adequate, the tissues do not receive enough oxygen and nutrients.

Pressure Ulcers

In advanced care settings, the most common site for pressure ulcer development is the sacrum (lower spine), with the heels being second

Phases of wound healing: The wound healing process begins as soon as the injury occurs and takes place in three phases:

The body's first priority is to stop the wound from bleeding. The injured blood vessels at the site of the injury constrict (narrow).

Remodeling Phase

The final stage of wound healing is the remodeling phase. This phase may last as long as 6 months for larger wounds. During the remodeling phase, more collagen is secreted to strengthen the wound. At the same time, collagen in the scar is broken down. This process is what causes the scar, which at first is raised, large, and red, to eventually shrink and become a flat, thin, white line.

Proliferative Phase

The proliferative phase begins 2 to 3 days after the injury and lasts up to 2 to 3 weeks in uncomplicated wounds. Wounds that are complicated stay in the proliferative phase for much longer.

Venous (Stasis) Ulcers

Venous stasis ulcers are seen on the lower legs, usually in the ankle area. They occur when loss of elasticity and decreased efficiency of the valves in the walls of the veins, makes it more difficult for the body to return blood to the heart. The blood "pools" in the veins, The pressure of the blood in the veins forces plasma out of the blood vessels and into the surrounding tissues. Swelling occurs, and the skin becomes fragile and inflamed. Eventually the skin breaks down, resulting in an open sore.

Unintentional wounds

are the result of an accident. Examples of unintentional wounds are those resulting from falls, motor vehicle crashes, and gun and knife violence. Because unintentional wounds are made by objects that are not sterile, they are usually contaminated with microbes. The edges of the wound are often uneven, making it difficult to close the wound. Healing is often complicated.

Open wounds

are wounds that break the skin and possibly involve the underlying tissues as well.

Closed wounds

are wounds that damage the tissues underneath the skin, but the skin it-self is not broken

Granulation tissue

is a thin layer of new tissue. It is red and bumpy in appearance because of all of the fragile new blood vessels and it bleeds easily.

Platelets (thrombocytes)

one of the three main types of blood cells stick together to form a temporary plug over the site of the injury. The platelets also release chemicals that react with fibrinogen (a type of protein form in the plasma) to form a more permanent clot.

Fibroblasts

produces collagen, a protein that adds strength to the healing tissues. Collagen pulls the edges of the wound together and forms scar tissue to filling the gap. Scar tissue replaces the tissue that is normally found in the area. Scar tissue is weaker than the normal tissue and is not able to function the way the normal tissues does. For example: scar tissue that replaces skin lacks blood vessels, hair follicles, sweat glands, and melanin, so it does not bleed, grow hair, sweat or tan.

To "Proliferate" means

to grow rapidly. During the proliferative phase, the body begins to replace the damaged tissue. Special cells called fibroblasts produce a thin layer of epithelial cells and promote the growth of new blood vessels.


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