Inflammatory Phase of Wound Healing

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The inflammatory phase of wound healing:
    • Is the body’s immediate response to injury:
      • Typically lasts from day 0 to about day 4 to 6:
        • Depending on wound severity and systemic factors
    • Its main goal is to:
      • Control bleeding (hemostasis)
      • Prevent infection
      • Lay the groundwork for tissue repair
    • Key steps of the inflammatory phase of wound healing:
      • Hemostasis (Minutes to Hours):
        • Vasoconstriction:
          • Damaged blood vessels constrict:
            • To reduce blood loss
        • Platelet plug formation:
          • Platelets adhere to exposed collagen:
            • Secondary to the trauma / injury:
              • Aggregate, and release factors:
                • Thromboxane A2
                • ADP
        • Coagulation cascade:
          • Fibrin mesh stabilizes the platelet plug:
            • Forming a clot (fibrin clot)
        • Growth factor release:
          • Platelets release:
            • PDGF
            • TGF-β
            • VEGF
              • Which recruit inflammatory cells (PMN) and initiate angiogenesis
      • Early Inflammation (Hours to ~ 48 hours):
        • Vasodilation:
          • Mediated by histamine, prostaglandins, and nitric oxide:
            • Leading to increased permeability
        • Neutrophil infiltration:
          • First responders:
            • Peak at 24 to 48 hours
          • Function:
            • Phagocytose bacteria and debris
          • Release reactive oxygen species (ROS) and proteolytic enzymes
          • Secrete cytokines (IL-1, TNF-α):
            • To amplify the inflammatory response
      • Late Inflammation / Transition (Day 2 to 5):
        • Monocyte to macrophage transition:
          • Monocytes migrate into tissue and differentiate into macrophages
          • Continue debris clearance
          • Secrete cytokines and growth factors:
            • TGF-β, VEGF, FGF:
              • That stimulate fibroblasts and angiogenesis
          • Switch from pro-inflammatory (M1) to pro-repair (M2) phenotype
          • Lymphocytes:
            • Arrive later:
              • Help regulate macrophage activity and fibroblast proliferation
  • Key Features of the Inflammatory Phase:
    • Cardinal signs:
      • Redness, heat, swelling, pain, and loss of function
    • Duration:
      • Normally resolves within 4 to 6 days:
        • Prolonged inflammation delays healing and predisposes to chronic wounds
    • Outcome:
      • Clean wound bed, bacterial control, and recruitment of cells for the proliferative phase:
        • Fibroblasts, endothelial cells, keratinocytes
Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment