Clean

Clean contaminated

Contaminated

Grossly contaminated 

Surgucal wound that became contaminated

Stiches come out

Wound that happend in a dirty area

Wound that sat there for awhile and continually gt dirty 

First intention (primary)

Second intention (secondary)

Third intention

First Intention Healing

(Primary)

Surgical incisions/clean wounds

Able to bring two tissues together and stitch them up to heal 

Minimal tissue loss

Lower risk for infection 

Second Intention Healing

(Secondary)

Left opened for healing large wounds

Allowing body to heal itself 

Fibroblasts and endothelial cells heal the wound

Granulation tissue - scars

Long healing time

Greater risk for infection

Delayed primary closure

Wound is cleaned and allowed to heal

Eventually closed 3 - 5 days after

Inflammatory

Proliferative

Remodeling

Inflammatory

(Early Wound Healing)

Hemostasis - clotting

Vasoconstriction

Plattlets go to injury

Clotting factors

Fibrin

Dilation - redness, heat, swelling

Congestion - pain, function loss, adema

Proliferative Phase

(Intermediate Wound Healing)

Mesenchymal cell migration and proliferation

Angiogenesis - capilarry formation 

Epithelialization - not as strong 

Remodeling Phase

(Late Wound Healing)

Collagen chages from type 3 to type 1

Cintraction - scar

Over months

Hypertrophic - occurs only at site of injury

Keloid - overhealing 

Medical - creams/gels

Surgical - risk of another scar

Dermabrasion

Laser