Understanding the Wound Healing Process

The wound healing process is a natural recovery response to damaged body tissue. Minor injuries can heal with self-care at home, but there are a number of medical conditions that make it difficult to heal. Wounds are injuries that involve damage to body tissue and commonly occur in the skin. The skin is the largest organ in humans and plays a role in protecting the body from microbes (viruses, fungi, bacteria). If the skin is injured, germs can easily enter the skin and cause infection. Scars, punctures, cuts and burns are all forms of injury. In addition, the former surgical suture is also classified into the wound. The most common causes of injury are sharp objects, falls, scalded, and accidents.

What is the wound healing process?

The wound can heal on its own through self-care at home. Independent wound care can be done if the wound is not too deep, not in a dangerous part of the body, for example on the face, and the bleeding stops in a short time or about 10 minutes. The wound healing process requires several stages, namely:

• Stage of inflammation or inflammation

In the early stages of the wound healing process, the blood vessels will narrow to stop bleeding. Platelets (cells that play a role in blood clotting) clot in the wound area. After the clotting is complete, blood vessels will dilate to drain blood into the injured area. This is the reason why the wound feels warm, swollen, and reddish. Then, white blood cells flood the area to prevent infection, by destroying bacteria and other microbes. White blood cells also produce chemicals that help repair damaged tissue. Furthermore, new skin cells grow to cover the wound area.

• Fibroblastic stage

This stage is the stage of formation of scar tissue after the wound. At this stage of wound healing, collagen begins to grow inside the wound. Collagen is a protein fiber that gives skin strength. The presence of collagen pushes the wound edges to shrink and close. Furthermore, small blood vessels (capillaries) form in the wound to provide blood intake to the newly formed skin.

• Maturation stage

Collagen production continues to grow so that the damaged tissue recovers slowly. The maturation process can take months or even years. This is why the longer the scars fade.

In order for the wound to heal properly, adequate wound care is needed. If necessary, some types of injuries may require bandages. After the damaged tissue is completely healed, the skin will be as strong as before the injury. However, the appearance of scarred skin may be different from normal skin. This is because the skin is composed of two proteins, namely collagen which gives skin strength, and elastin which gives skin flexibility. In scars, the skin cannot produce new elastin, so the scars are made entirely from collagen. The skin on this scar is strong, but less flexible than the surrounding skin.

Specific Conditions That Cause Difficult Wounds to Heal

There are several conditions that cause difficult wounds to heal, namely:

• Bleeding

Bleeding makes it difficult to close the wound, making it difficult to heal.

• Foreign object

Foreign bodies, including dead skin tissue, inhibit the wound healing process. Dirty wounds are also susceptible to germ infections so the wound healing process can be disrupted. Therefore, it is very important to clean the wound and treat the wound properly.

• Friction

Friction wounds with clothes can worsen the condition. It is recommended to wear soft clothing and close the wound to avoid friction.

• Age

Wounds tend to heal longer in older people.

• Nutritional deficiencies

Lack of nutrients such as vitamin C, protein, and iron, can inhibit the wound healing process.

• Smoke

Research shows that the healing process of wounds in smokers is much longer and imperfect than nonsmokers. This is thought to be related to the effect of smoking which can interfere with the performance of white blood cells and disrupt blood flow, as well as high levels of toxins in the blood.

• Stress

Physical and psychological stress have been proven to influence the inhibition of the wound healing process. This is thought to be related to the effect of stress on the low amount of oxygen in the blood so that the wound healing process takes longer. When experiencing stress, a person is also more likely to undergo unhealthy behaviors, such as smoking and consuming excessive alcohol, thus contributing to wound healing.

• Treatment

Injuries in patients undergoing dialysis procedures, chemotherapy, treatment with corticosteroids or blood thinning drugs, tend to be more difficult to heal.

• Disease

The process of wound healing is greatly influenced by blood flow and the role of white blood cells as part of the body's immune system. Diseases related to blood, such as anemia and vascular disease, can reduce blood supply to the wound tissue thereby slowing down the recovery process.

Diabetes is also one of the conditions that makes it difficult to heal wounds. Wounds in diabetics tend to be more difficult to heal. Even small wounds can get worse quickly and become a dangerous infection if not treated immediately. Foot injuries are the most common injuries in diabetics. In severe cases, foot amputation must be done so that the infection does not spread. The slow wound healing process is caused by high blood sugar levels. Blood sugar that is too high will reduce blood flow, inhibit cells from getting nutrients and oxygen, disrupt the immune system, and increase the risk of inflammation. This condition will certainly hamper the wound recovery process. The time needed for a wound to fully heal depends on the condition of the wound. The bigger, deeper, and dirtier the wound condition, the longer the healing process. If you have a serious injury or bleeding from a wound that does not stop, you should seek help from a doctor or health care provider and undergo wound care at the hospital.