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Wound Healing

Elisabeth Prajanti Sintaningrum

Wound healing repair or reconstruction
of a defect in an organ or tissue

Organisms global response to injury

One of the most complex physiologic

processes that occurs in life
Scar Formation vs Tissue Regeneration

Wound healing a broad and complex topic

that covers a variety of responses to injury in a
variety of different organ systems

Represents the response of an organism to a

physical disruption of a tissue/organ to re-
establish homeostasis of that tissue/organ and
to stabilize the entire organisms physiology
Scar formation
susbtitution of a different cellular matrix as a
patch to immediately re-establish both a physical
and physiologic continuity to the injured organ

Recapitulation of the developmental processes
that initially created the injured organ, by
reactivating developmental pathways the
architecture of the original organ is recreated

The dynamic balance between scarring and

tissue regeneration is different in different
tissues and organs
Scar formation is not always bad, tissue regeneration is not always good

Important to consider the possible adaptive role that the dysfunctional

process might have

Response to injury in different tissues involves differebt proportions of

scar formation and tissue regeneration

The failure of either scar formation or regeneration may lead to similar

appearing clinical problems that have a completely different underlying
Acute wound
wound that has occured within the past 3 to 4 weeks

Chronic wound
the wound persists beyond 4 to 6 weeks, including wounds that
have been present for months or years
Granulatting appereance in the wound cavity of granulation
tissue and is a sign that suggests that the wound is progressing,
albeit slowly

Nonhealing wound & delayed healing wound

chronic wound
Phases of Normal Wound Healing

Inflammatory Proliferative Remodelling

Phase Phase Phase
Phases of Normal Wound Healing
Phases of Normal Wound Healing

Inflammatory phase
Begins immediately following tissue
attainment of hemostasis
removal of dead and devitalized tissue
prevention of colonization and invasive
infection by microbial pathogens
Inflammatory phase
Proliferative Phase
Occuring 4 to 21 days after injury
Balance between scar formation and tissue
regeneration occurs
Remodelling Phase
Occuring from 21 days up to 1 year
The longest part of wound healing
To maximize the strength and structural intergrity of
the wound
Abnormal Response to Injury and
Abnormal Wound Healing
Inadequate Regeneration Underlying an Abnormal Response
to Injury

Inadequate Scar Formation Underlying an Abnormal

Response to Injury

Excessive Regeneration Underlying an Abnormal Response to


Excessive Scar Formation Underlying an Abnormal Response

to Injury
The normal responses to injury occur in different tissues
and different species

Dynamic balance of scar formation & regeneration

New therapeutic strategies to correct imbalances by

either augmenting or suppressing one component or
the other

May provide a basis for accelerated progress in the care

of patients with abnormal or dysfunctional responses to
injury that result in human disease