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Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
Granulation tissue is new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process. [1] Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any size. Examples of granulation tissue can be seen in pyogenic granulomas and pulp polyps.
However, this white skin should not be confused with the pale, whitish appearance of the new epithelial tissue in a healing wound. Although most maceration clears up quickly once the skin is exposed to fresh air and allowed to dry, sometimes skin that experiences long periods of maceration is vulnerable to fungal and bacterial infection .
In a major injury, if epithelial cell migration and tissue contraction cannot cover the wound, suturing the edges of the injured skin together, or even replacement of lost skin with skin grafts, may be required to restore the skin. As epithelial cells continue to migrate around the scab, the dermis is repaired by the activity of stem cells.
A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. [1] [2] Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying disease processes such as diabetes mellitus, venous/arterial insufficiency, or immunologic disease. [3]
The periwound (also peri-wound) is tissue surrounding a wound. Periwound area is traditionally limited to 4 cm outside the wound's edge but can extend beyond this limit if outward damage to the skin is present. Periwound assessment is an important step of wound assessment before wound treatment is prescribed. [1]
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