- The loss of all or part of the function of organs
- Sympathetic stress response
- Bleeding and blood clots
- Bacterial contamination
- Cell death
Mechanism of injury:
- Incision (Incised Wounds)
- Bruise (contusion Wound),
- Abrasions (Abraded Wound),
- Stab wound (punctured Wound),
- Laceration (Lacerated Wound),
- Penetrating injuries (Penetrating Wound),
- Burns (combustio)
According to the level of contamination of the wound:
- Clean Wounds (clean wounds),
- Clean-contamined Wounds (clean contaminated wounds),
- Contamined Wounds (Wound contamination),
- Dirty or Infected Wounds (dirty wounds or infections),
Based on the depth and extent of injury, divided into:
- Stage I: Wound superficial "Non-blanching Erithema"
- Stage II: Wounds "Partial Thickness"
- Stage III: Wounds "Full Thickness"
- Stage IV: Wounds "Full Thickness"
According to the wound healing time is divided into:
- Acute Wounds
- Chronic Wounds
The healing process includes several phases:
- Phase Inflammation
- Proliferative Phase
In the normal soft tissue (without injury), exposure fibroblasts are very rare and usually hide in supporting tissue matrix. After the event of injury, activated fibroblasts will move from the tissue around the wound into the wound area, then it will evolve (proliferation) and secrete some substance (collagen, elastin, hyaluronic acid, fibronectin and proteoglycans) that play a role in building (reconstruction) the new network. More specific functions of collagen is formed the embryo of new tissue (connective tissue matrix) and the issuance of the substrate by the fibroblasts, providing indication that macrophages, new blood vessels and fibroblasts as well as an integrated unit to enter the wound. A number of cells and new blood vessels are embedded in the new network is called the network "granulation". Proliferative phase ends if the epithelial layer of the dermis and collagen has been formed, visible contraction process and will be accelerated by various growth factors formed by macrophages and platelets.
- Phase maturation
Wounds heal in the event said continuity layers of skin and scarring force capable or do not bother to do normal activities. Although the wound healing process the same for every patient, but the outcome or the result achieved is highly dependent on the biological condition of each individual, the location and extent of injuries. Patients young and healthy will achieve rapid process compared with malnutrition, accompanied systemic disease (diabetes mielitus).
Factors affecting wound healing:
- Foreign body
- Steroids: mechanisms will decrease the body's normal inflammatory response to injury
- Anticoagulants: causing bleeding
- Antibiotics: Effective administered immediately before surgery for specific bacteria that cause contamination. If given after the surgical wound is closed, will not be effective due to intravascular coagulation.