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W.H. Auden, "The Art of Healing"
Wound healing is a natural restorative response to tissue injury. Healing is the interaction of a complex cascade of cellular events that generates resurfacing, reconstitution, and restoration of the tensile strength of injured skin.
Healing is a systematic process, traditionally explained in terms of 4 overlapping classic phases: hemostasis, inflammation, proliferation, and maturation. While platelets play a crucial role in clot formation during hemostasis, inflammatory cells débride injured tissue during the inflammatory phase. Epithelialization, fibroplasia, and angiogenesis occur during the proliferative phase. Meanwhile, granulation tissue forms and the wound begins to contract. Finally, during the maturation phase, collagen forms tight cross-links to other collagen and with protein molecules, increasing the tensile strength of the scar.
For the sake of discussion and understanding, the process of wound healing may be presented as a series of separate events. In actuality, the entire process is much more complicated, as cellular events that lead to scar formation overlap. Many aspects of wound healing have yet to be elucidated.
An image depicting a hypertrophic scar can be seen below.Hypertrophic scarring and keloids. Hypertrophic sc
Hypertrophic scarring and keloids. Hypertrophic scars on neck with raised features within scar margins.
For further reading, please see Medscape’s Wound Management Resource Center
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