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Abstract
One of the most fascinating features of the human body is its ability to repair damaged tissue. When the skin is injured a complex process occurs. The natural healing process can be divided Into four distinct stages: inflammatory, granulation, epithelization and maturation. This process can take up to 2 years. Brunner and Suddarth (1992) classified wound healing into three stages: primary; secondary, and tertiary. Many factors affect how long a wound will take to heal, eg. concurrent illnesses, nutritional status and the dressing used. A holistic approach to wound care is the key, and if all the factors are not addressed then wound healing will not prevail.
A complex set of events occurs upon injury to the skin, which appear to be relatively simple but, in fact, are exceptionally complicated giving rise to physical and chemical reactions and cellular episodes. Flanagan (1996) states that 'wound healing can be defined as the physiological process by which the body replaces and restores the function of damaged tissue'. Despite the large amount of research that has been undertaken in this field, there are still areas which are not properly understood.
WOUND HEALING
The natural healing process can be divided into four stages: infammatory, granulation, epithelization and maturation.
Inflammatory process: The inflammatory process is a 'biological emergency' response with a latent stage of about 12 hours before any obvious healing begins (Silver, 1994). However, the activity before this is very concentrated with many complex chemical events occurring. Once an injury has been sustained by the body, platelets are released from the blood vessel, which initiate haemostasis coagulation of blood leaking from damaged, inflamed, dilated blood vessels (Kerstein, 1997). At the same time a biochemical cascade occurs that liberates thrombokinase and this is converted to thrombin. The clots from fibrinogen are converted to fibrin, which covers the wound, and brings the wound edges together. Neutrophils (white blood cells) are attracted into the wound within hours of injury. A series of elaborate messages are initiated which cause blood cells to proceed to the site of the injury bringing extra oxygen supplies to the wound and phagocytes to clear tissue debris.
Also, there is release of growth factors, several cytokines which include regulatory peptides and glycopeptides (Hopkinson, 1992). On...