Wound Healing Essay

1144 words - 5 pages

Wound healing is a complex process for the body. There are many factors that are involved in the process of wound healing. Surgical technologists need to be aware of how wounds are classified to show level of contamination, the healing process, complications that can delay healing to patients, and the implications.
According to J. Zinn (2012), “In 1964, the National Academy of Sciences National Research Council1 published its land- mark study on the use of ultraviolet lights in the OR, and the era of classifying wounds by the contamination present (or the potential for contamination) began.” The categories for wound healing were originally put into place by The American College for surgeons ...view middle of the document...

135). Next, is second intention wound healing or spontaneous wound healing (S. Zinn, n.d.). This wound is left open to heal by the body’s natural ability of epithelialization and formation of granulation tissue (Mulholland and Doherty, 2006, p. 135). It is often used for an infected or contaminated wound. Third intention or tertiary wound healing is a delayed primary closure. The wound has to high of a bacterial count or inflammation to be closed right away. Therefor more debridement and time allow for the bacteria and swelling to subside. Once the bacteria levels have dropped the wound will be closed and left to heal by primary intention (S. Zinn, n.d.). Another aspect of tertiary wound healing is when a skin graft is placed over the wound (Mulholland and Doherty, 2006, p. 135). Lastly, fourth intention healing is partial thickness wound healing. This is a typical burn or abrasion that is allowed to just heal and be left alone with no surgical intervention (S. Zinn, n.d.).
Wound healing takes place in stages. The earliest stage is the vascular response to a wound (Government, 2009). Next is the lag phase in which inflammation has set in. It is during this time period that the wound is most vulnerable to complications (Mulholland and Doherty, 2006, p.131). During this time neutrophils and macrophages rush to the site and begin to attack any foreign bodies (Government, 2009). Proliferation phase starts around postoperative day 2-3. This is when the fibroblasts begin to replace the fibrin rich matrix that was placed during the lag phase (Mulholland and Doherty, 2006, p.130). Epithelialization and granulation occur resulting in skin growth. Following this phase is the maturation phase, which lasts about one year. The scar tissue begins to gain more strength. (Government, 2009). Along with healing that takes place it does leave room for complications in the wound healing process.
Complications can always arise in the wound healing process. Hypertrophic scars are raised and very evident. Keloids are hypertrophic scars that extended beyond the original scar area (Mulholland and Doherty, 2006, p.136-137). Wound dehiscence is when there is an opening of the surgical wound. This is most common during the first two weeks following surgery. Evisceration is a serious complication in which the organ is protruding out of the wound. Excessive coughing, lifting, and improper care can cause these complications (Heisler, 2011). Traumatic emphysema can also occur; this is when air or gas gets into the...

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