Tissue healing

As the skin is the body’s outermost structure, it is always affected when there is a wound; even for many superficial wounds, the skin will be the only damaged bodily structure.

Accidents at home, falls, sunburn, cuts, abrasions, etc. There are many situations in which skin injuries can occur, so it is important to know about the tissue healing process, as well as how to treat a wound.

The tissue must regenerate in order to heal properly. The healing process is not the same for all individuals, it depends on multiple factors: age, nutrition, health status, drug intake, etc. The healing process can be aided by adopting specific care methods.

What is healing and how does it take place?

Healing is the biological process whereby skin is restored following damage. It involves a number of successive phases:

• A vascular and inflammatory phase lasting about 3 days, in which the clot forms and microorganisms, dead cells and necrotic tissue are destroyed.
• A proliferative phase lasting about 15 days, in which the body produces collagen and the fundamental substances needed to form new tissue. The scar begins to contract.
• A final scar maturation and tissue remodelling phase that last several months. The collagen fibres intertwine following the skin's tension lines. The tissue regains its original appearance.

Occasionally, alterations may occur in this last phase of the remodelling that lead to the formation of pathological scars, such as hypertrophic or keloid scars.

How to help a wound heal

For cuts, abrasions, sunburn or superficial burns and ulcers, the steps to follow are:

• Assess the depth of the wound.
• If the wound is superficial, only wash it with drinking water or saline solution. If the wound has dirt inside, wash it with a neutral soap.
• Disinfect it with antiseptics when there are signs of infection or there might be an infection.
• Apply hydro-polymer dressings while the wound is inflamed and suppurating.
• Once the skin regeneration process begins, cover the wound with a hydrocolloid dressing (self-adhesive, thin and transparent sheets) or with a hydrogel sheets, as it is necessary so as to prevent the wound from drying out.
• During the final phase of epithelialisation, apply tissue healing gels or creams that provide moisture and active ingredients to stimulate skin repair, such as Aloe Vera or Panthenol, to prevent dryness, hyperkeratosis, itching and possible scratching.

Factors that interfere with the healing process

There are multiple factors that influence the delicate biological healing process:

• Age. The biological activity and ability to synthesise new tissue to form the scar is inversely proportional to the age of the patient.
• Nutrition. Vitamins such as ascorbic acid, vitamin A, vitamin E or trace elements such as zinc, manganese or copper can play an important role in the healing process.
• Infection. Attention should be paid to any signs and symptoms of infection, because when there is an infection, the healing process stops, while increasing the inflammatory reaction and the generation of exudate.
• Oxygen. The presence of oxygen in the bed of the wound is necessary for leukocyte function, cell migration and multiplication, collagen synthesis and intermolecular bridge formation.
• Hormones. Growth hormone (GH) and androgens promote healing.
• Drugs. Certain drugs negatively interfere with the healing process. Among others, the following stand out: corticosteroids, cytostatics and immunosuppressants, povidone-iodine, penicillin, adrenaline, nicotine.
• Associated diseases. Diabetes, for example, is a risk factor for infection.