2.3 Explain the process of wound healing and identify factors which promote and delay the process

This guide will help you answer 2.3 Explain the process of wound healing and identify factors which promote and delay the process.

The Process of Wound Healing

Wound healing is a natural response to injury. It is the way the body repairs and protects itself after the skin or tissue is broken, cut, burnt, or punctured. Healing moves through predictable stages, though the speed and success can differ for each individual.

Let’s look at this process step by step:

Haemostasis (Stopping the bleeding)

This is the first thing the body does when a wound occurs. Blood vessels around the wound tighten (constrict) to reduce blood loss. Platelets (a type of blood cell) stick together and form a clot to seal the broken blood vessels.

What happens during haemostasis:

• Blood flow lessens quickly after injury.
• A clot forms, made up of platelets and a protein called fibrin.
• The clot acts as a temporary barrier to germs.

Inflammation

Inflammation is the next phase. It starts within minutes of the wound. The body sends special white blood cells to the area to clean it. These cells eat (phagocytose) any dirt, dead cells, or germs.

Key points about inflammation:

• The area might look red, swollen, and feel warm.
• There may be mild pain, a normal part of this cleaning up.
• The body releases substances, such as histamines, that widen blood vessels and bring more blood (and healing cells) to the wound.

Proliferation (Building new tissue)

Once cleaning is underway, the body begins to fix the wound. New tissue replaces what was damaged. This phase can last from a few days to several weeks.

Here’s what happens:

• New blood vessels form (angiogenesis), improving blood supply.
• Fibroblast cells make collagen, a strong protein that gives skin its stretch and strength.
• The wound starts to fill in with new tissue (granulation tissue).
• Skin cells (epithelial cells) spread across the wound surface to close it.

Maturation and Remodelling

This last stage can continue for months, or even over a year. The body makes the healed area stronger by changing and arranging the collagen fibres.

What to know about maturation:

• Collagen fibres re-align along tension lines, making the area tougher.
• The scar gradually gets softer and paler.
• The wound may regain up to 80% of its original strength, but rarely 100%.

Factors That Promote Wound Healing

Healing can be faster and better when certain things are present.

Good Nutrition

Eating a healthy, balanced diet is important. Protein builds new tissue, vitamin C helps collagen formation, and zinc aids cell division.

Eating well-promotes healing:

• Plenty of fruits and vegetables give vitamins and minerals.
• Protein sources help tissue repair (like fish, meat, eggs, beans).
• Staying hydrated keeps cells functioning well.

Cleanliness and Hygiene

Keeping wounds clean prevents infection, letting the body focus on repair.

Ways to support healing:

• Regular hand washing before touching the wound.
• Using clean dressings.
• Cleaning the area gently with suitable solutions.

Good Blood Supply

Strong blood flow carries oxygen and nutrients to the wound. It removes waste products.

Factors that improve circulation:

• Gentle exercise (if appropriate and safe).
• Avoiding tight dressings.
• Keeping warm (cold slows blood flow).

Moist Environment

A slightly moist wound surface speeds up healing by helping new cells move and grow.

Benefits include:

• Less scab formation.
• Easier movement for healing cells.
• Quicker tissue repair.

Moist wound dressings should not be wet enough to cause maceration (softening or breakdown of healthy skin).

Managing Health Conditions

Illness can slow healing. Conditions that are well-managed give the body a better chance.

Examples include:

• Keeping diabetes under control.
• Treating any infections quickly.
• Following doctor’s advice on medication.

No Smoking or Excessive Drinking

Tobacco and heavy alcohol use both restrict blood flow and slow healing. Stopping these can let wounds heal more quickly.

Factors That Delay Wound Healing

Certain situations make healing more difficult.

Infection

When germs enter the wound, they can cause inflammation and slow the repair process. An infected wound might smell bad, become redder, swell, or ooze pus.

Always watch for:

• Increased pain.
• Heat around the wound.
• Discharge or odour.

Poor Nutrition or Dehydration

Without enough vitamins, minerals, or protein, the body cannot make new cells or form strong scar tissue. Lack of fluids affects cell function and slows repair.

Chronic Diseases

Long-term medical conditions such as diabetes, heart disease, and vascular disease reduce blood supply or affect the immune system.

How chronic diseases delay healing:

• High blood sugar damages small blood vessels, reducing oxygen to the wound.
• Heart or vascular disease limits blood flow to tissues.

Poor Blood Supply

Blocked or narrowed arteries prevent healing cells from reaching the wound. This can happen with age, blood clots, or diseases.

Symptoms of poor blood flow:

• The area around the wound feels cold.
• The skin may look pale or blue.
• The wound does not seem to get better, or new wounds keep appearing.

Age

Older skin is thinner and has less blood flow. Elderly people often heal more slowly, and their wounds may be more easily infected.

Medication

Some medicines affect healing.

Examples:

• Steroids suppress inflammation but also slow new tissue growth.
• Chemotherapy can damage healthy cells, including those needed for wound healing.

Repeated Trauma or Pressure

If a wound is knocked, scratched, or rubbed often, healing tissue can be damaged. Lying or sitting in one position too long can lead to pressure ulcers.

Ways this can happen:

• Bed-bound individuals not moved regularly.
• Using tight footwear or bandages.

Stress

Physical or emotional stress can affect hormones and immune cell activity. This can slow down healing or lead to complications.

Smoking and Alcohol

Smoking narrows blood vessels, reducing oxygen and nutrients. Alcohol abuse can weaken the immune system.

Dry or Wet Wound Environment

A wound that dries out too much forms a hard scab, making it hard for skin cells to move across. Overly wet environments lead to maceration and breakdown of new tissue.

Poor Wound Care

Not changing dressings, using dirty materials, or failure to follow instructions can slow down or prevent healing.

Recognising and Responding to Complications

Knowing when a wound is not healing as expected is key. Delayed healing needs action. Slow progress or signs of infection must be reported to a nurse, doctor, or care manager.

Look out for:

• A wound that does not shrink or close over time.
• New pain or bleeding.
• Signs of spreading infection, like fever or red streaks from the wound.

Taking swift steps protects the person’s health and can prevent serious issues.

Supporting Others with Wound Care

Good wound care is part of high-quality health and social care. Workers help by following care plans, keeping areas clean, and watching for issues. Always use personal protective equipment, like gloves, to protect yourself and the person you are caring for.

Every person is different, so care should match the individual’s needs. Good records help track progress and spot any changes early.

Final Thoughts

Supporting wound healing needs understanding and attention. Every phase of the process is important, from stopping bleeding, cleaning, and tissue building, through to long-term strengthening. Each step of care matters, whether choosing the right dressing, supporting healthy habits, or managing disease.

Recognising factors that help or slow healing allows you to spot issues and act early. Your role in this process is vital. You help keep wounds clean, encourage healthy eating, and spot signs when something is wrong. Together, these actions give people the best chance for a safe and speedy recovery. Your care makes a real difference.