Avian (Bird) Anatomy - Images of Bird Wound Healing Processes

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WOUND HEALING

Wound Healing by First, Second, And Third Intention http://medical-dictionary.thefreedictionary.com/wound+healing

First Intention (Primary Intention)

  • per primam; union of accurately coapted edges of a wound, with an irreducible minimum of granulation tissue.
  • The tissue is restored by fibrous adhesion, without the formation of granulation tissue; it results in a thin scar. In primary wound healing there is no tissue loss.

A, Incised wound is held together by a blood clot and possibly by sutures or surgical clamps. An inflammatory process begins in adjacent tissue at the moment of injury.

B, After several days, granulation tissue forms as a result of migration of fibroblasts to the area of injury and formation of new capillaries. Epithelial cells at wound margin migrate to clot and seal the wound. Regenerating epithelium covers the wound.

C, Scarring occurs as granulation tissue matures and injured tissue is replaced with connective tissue.

Wound Healing by First, Second, And Third Intention

Wound Healing By First Intention (primary wound healing or primary closure) http://www.medstudentlc.com/page.php?id=67

  • Describes a wound closed by approximation of wound margins or by placement of a graft or flap, or wounds created and closed in the operating room.
  • Best choice for clean, fresh wounds in well-vascularized areas
  • Indications include recent (<24h old), clean wounds where viable tissue is tension-free and approximation and eversion of skin edges is achievable.
  • Wound is treated with irrigation and debridement and the tissue margins are approximated using simple methods or with sutures, grafts or flaps.
  • Wound is treated within 24 h following injury, prior to development of granulation tissue.
  • Final appearance of scar depends on: initial injury, amount of contamination and ischemia (inadequate blood supply), as well as method and accuracy of wound closure; however, they are often the fastest and most cosmetically pleasing method of healing.

Wound Healing By Second Intention. (per secundam; union by adhesion of granulating surfaces) http://medical-dictionary.thefreedictionary.com/wound+healing

  • WOUND HEALING occurs by adhesion of granulating surfaces, when the edges of the wound are far apart and cannot be brought together.
  • Granulations form from the base and sides of the wound toward the surface
  • There is tissue loss, as in extensive burns and deep ulcers.
  • The healing process is more prolonged than in healing by primary intention because large amounts of dead tissue must be removed and replaced with viable cells.

A, Open area is more extensive; inflammatory reaction is more widespread and tends to become chronic.

B, Healing may occur under a scab formed of dried exudate, or dried plasma proteins and dead cells (eschar).

C, Fibroblasts and capillary buds migrate toward center of would to form granulation tissue, which becomes a translucent red color as the capillary network develops. Granulation tissue is fragile and bleeds easily.

D, As granulation tissue matures, marginal epithelial cells migrate and proliferate over connective tissue base to form a scar. Contraction of skin around scar is the result of movement of epithelial cells toward center of wound in an attempt to close the defect. Surrounding skin moves toward center of wound in an effort to close the defect. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved .

Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved

Healing By Second Intention (secondary wound healing or spontaneous healing) http://www.medstudentlc.com/page.php?id=67

  • Describes a wound left open and allowed to close by epithelialization and contraction.
  • Commonly used in the management of contaminated or infected wounds.
  • Wound is left open to heal without surgical intervention.
  • Indicated in infected or severely contaminated wounds.  Unlike primary wounds, approximation of wound margins occurs via reepithelialization and wound contraction by myofibroblasts.
  • Presence of granulation tissue.
  • Complications include late wound contracture and hypertrophic scarring

Wound Healing By Third Intention or Delayed Primary CLOSURE. http://medical-dictionary.thefreedictionary.com/wound+healing

  • WOUND HEALING by the gradual filling of a wound cavity by granulations and a cicatrix (a scar resulting from formation and contraction of fibrous tissue in a wound)  
  • The method of closing a grossly contaminated wound in which the wound is left open until contamination has been markedly reduced and inflammation has subsided and then is closed by first intention.
  • The restoration of structure and function of injured or diseased tissues.
  • The healing processes include blood clotting, tissue mending, scarring and bone healing.

Healing By Third Intention (tertiary wound healing or delayed primary closure) per tertiam; union of a wound that is closed surgically several days after the injury. See also delayed primary closure http://www.medstudentlc.com/page.php?id=67

  • Useful for managing wounds that are too heavily contaminated for primary closure but appear clean and well vascularized after 4-5 days of open observation. Over this time, the inflammatory process has reduced the bacterial concentration of the wound to allow safe closure.
  • Subsequent repair of a wound initially left open or not previously treated. 
  •  Indicated for infected or unhealthy wounds with high bacterial content, wounds with a long time lapse since injury, or wounds with a severe crush component with significant tissue devitalization.
  • Often used for infected wounds where bacterial count contraindicates primary closure and the inflammatory process can be left to débride the wound.
  • Wound edges are approximated within 3-4 days and tensile strength develops as with primary closure.

Partial Thickness Wounds

  • Wound is superficial, not penetrating the entire dermis.
  • Type of healing seen with 1st degree burns and abrasions.
  • Healing occurs mainly by epithelialization from remaining dermal elements.
  • Less contraction than secondary healing in full-thickness wounds
  • Minimal collagen production and scar formation.

Granulomatous tissue in wound healing

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Granulomatous tissue in wound healing

Bumblefoot

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Bummble Foot