Wound healing, whether traumatic or surgical, is caused by scarring. It is a natural and dynamic process that goes through many stages. The correct development of each is important to ensure the formation of a good scar that does not affect the function or beauty of the injured area.
Treatment: divided into two stages and four phases
Static therapy takes place in two main stages:
Primary scarring
Scar Maturation
The two main stages are completed in several stages at different times. Understanding these different stages is useful in identifying abnormalities that may arise during treatment, thus avoiding infectious, functional or cosmetic problems. Step One: Designing the Scale
It is done in three different stages:
1 – Inhibitory or inflammatory phase
Immediately after the wound is created, local blood vessels dilate, increasing vascular permeability and plasma leakage. This vasodilation is quickly followed by vasoconstriction, which reduces bleeding by forming blood clots at the base of the wound thanks to the special properties of platelets.
Then, pro-inflammatory cells (white blood cells and macrophages), attracted by chemotactic agents, reach the tissue to clean the wound, eliminate dead tissue, bacteria and microbes.
This stage starts between 12 and 24 hours and causes symptoms of redness (erythema), swelling (edema), pain and increased fever.
In severe pain (injury or surgery), it should be separated to the next stage and last 1 to 4 days.
2 – Budding stage or granulation tissue formation
During this time, cells called fibroblasts (connective tissue) appear in abundance, stimulated by macrophages. Fibroblasts produce more collagen, elastin, and other components of the dermal cell matrix.
At the same time, cells in blood vessels (endothelial cells) sprout at the ends of damaged capillaries. The buds in the resulting collagen network give the wound its reddish and granular appearance, hence the stage name. This growth stops when granulation tissue replaces the lost material and fibroblasts reach the wound. This process begins on day 4 and ends on day 15.
3 → Epidermalization phase
When the tissue reaches its maximum level, collagen fibers are re-formed. At the same time, epithelial cells appear and migrate towards the wound. Therefore, the wound shrinks and is covered with epithelial cells, which corresponds to the closure of the wound from a primary scar that is close to the skin around the wound.
The first scar formation is made on day 21, except for superficial wounds with small stitches, in which case epithelialization is observed after 24 hours. Step 2: Scars begin to grow
This is the fourth stage of the treatment:
Once a scar has formed, around the 25th or 30th day, collagen begins to deteriorate significantly, marking the beginning of the first wound healing. During this time, the wound edges continue to slow down under the influence of myofibroblasts, strengthening the relationship between the epidermis and the dermis. As a result, the scar gradually becomes elastic, smooth and softer to the touch.
This change will result in a final scar after 6 months to a year or more.
The quality of the final scar depends on its size, location and especially the beginning of healing, which is why attention and care during scarring are of great importance. Alterations in the healing process of wounds can cause prolonged and difficult pain that requires special care with dressings and supplies to correct the “Say” call, or can create visual impairment, abnormality, and even functional ability. .