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Wound Healing Case Study

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1. Explain the process of wound healing by primary intention. Healing by primary intention occurs when there is no tissue loss and the wound has well-opposed edges, eg. surgical incision. The three phases in wound healing are inflammatory, proliferative and remodeling. Inflammatory Phase The process of wound healing starts off with coagulation. Blood vessels at the wound site will first constrict to induce clot formation. Once a clot is formed, inflammation occurs as the blood vessels dilate to transport white blood cells, antibodies, macrophages and neutrophils to the wound site. Oedema, redness, heat and pain can be observed. Proliferative Phase Granulation tissue which is made up of collagen and extracellular matrix will be formed at the wound. Granulation tissue is a richly vascular connective tissue containing new capillaries (formed by angiogenesis), proliferating myofibroblasts and a variable number of inflammatory cells such as macrophages and plasma cells. This acts as a barrier to infection and a frame where new tissue can grow. Essential nutrients for new tissue growth are also supplied by the granulation tissue. Remodeling Phase At this stage, granulation tissue is replaced by fibrous tissue. Connective tissue is remodeled to achieve wound strength. Parenchymal tissue is remodeled to restore tissue function. Excessive extracellular …show more content…

He had ileostomy. He had a midline incision below the umbilical scar. The superior and inferior 1/3 of the wound is healed by primary intention while the middle 1/3 of the wound is healed by secondary intention. There was pus flowing out from the wound as it is infected and inflamed. His anterior rectum and colon was anastomosed, and a stoma bag was installed at his right abdomen. After the operation, he had ileus as there was a leak at the anastomosis site. This further caused him to be malnourished as he had not been eating for the past 10 days and he vomited whenever food is

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