The wound healing process.

The field of wound repair continues to grow at an astounding pace. In this review we have discussed both the basic science and the clinical aspects of wound healing. The basic science section details the three phases of wound healing. The inflammatory phase is marked by platelet accumulation, coagulation, and leukocyte migration. The proliferative phase is characterized by re-epithelialization, angiogenesis, fibroplasia, and wound contraction. Finally, the remodeling phase takes place over a period of months, during which the dermis responds to injury with the production of collagen and matrix proteins and then returns to its preinjury phenotype. The second part of this review outlines selected practical clinical aspects of wound repair. That section is subdivided into acute and chronic wounds. We describe the difference between primary and secondary intention healing and discuss factors that affect healing in both. We also describe our systemic approach to dealing with patients with chronic wounds and present our problem-oriented treatment program based on the cause of the chronic wound.