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It is important to note that this pertains mainly to the healing of a wound after tissue injury or damage and not so much to the healing of your heart after someone metaphorically stabs it or something of that nature. Also, this is only a very basic outline of the healing process and what it entails. There are of course numerous details one could delve into - and you can go ahead and do this, you know, on your own time. It's important to note that when you are healing any kind of wound you should try to keep in mind that the body functions best when it has the right amount of nutrients and also you should sleep. The body does a lot of healing when you are asleep, so don't just stay up all night staring at it. If it's a serious injury pain medication may be necessary and can help with the sleeping part - but don't go overboard on the narcs. Eat lots of protein, too. Cells like that stuff.

If your injury is on a joint or is quite extensive, avoid running around a bunch or doing strenuous activity that might delay or disrupt the healing process. This applies to all but is especially true of surgical wounds - but the surgeon should discuss this with you prior.

Wound healing can be delayed by a number of factors and is especially difficult for diabetics. This healing process talks more about an acute injury than something like a diabetic ulcer, but most of it will hold true in both cases. The diabetic wound simply takes much longer to heal and depending on the severity it may be impossible to achieve a full recovery, especially if the patient is older. Notably, anyone who has an impaired immune response (which involves step 2 of this process - inflammation) - will experience delayed wound healing in most cases. 

So there are a few types of healing - you can call them whatever you like but for the purposes of this node and because that is how my textbook lays them out, there are three main catgeories or ways that a wound can heal:

Resolution - this type of healing occurs in cases where minimal tissue damage has occurred. The tissue returns to its original state relatively quickly as it might with a small cut or a mild burn. I guess one might say that this would be the preferred method of healing if you had to choose one in the first place.

Regeneration - this type of healing can occur in a more serious tissue injury as long as some of the cells involved are still capable of mitosis. The damaged tissue is replaced by the same type of tissue via cells having all kinds of intercourse. Interestingly enough, the result may be dysfunctional tissue as might occur when more complex cells are damaged as in the case of certain types of organ tissue. The structure may return but it might not participate in the function of the organ any longer. This is sort of unfortunate for obvious reasons.. and kind of creepy. Cells freak me out, sometimes.

Replacement - and this leaves us with the last type of healing, replacement. It is just as it sounds - the replacement of badly damaged tissue by a scar (connective tissue) because your poor cells are no longer capable of mitosis. An area where this might occur is the Central Nervous System or it may also occur in areas where inflammation persists for a very long period of time.

That being said, let's break this process down into some very simple steps: 

1. The formation of the blood clot. This serves to seal in the injured area and provide some protection. Also you won't bleed to death, hopefully.

2. The inflammatory response occurs.

3. A few days after the initial injury, most foreign material and cell debris have been removed from the injured tissue by bodily processes. (Or someone pulls out the dagger? Stuff like that I think.)

4. On about the 5th to 7th day granulation tissue begins to grow into the gap from nearby connective tissue. This granulation tissue is highly vascular in nature and appears pink or red as a result. It is also very fragile and is therefore easily broken down. Stop touching it!! Don't poke at your wound. Oh look what you went and did... geez. Start back at 1.

5. While the granulation tissue is forming, so are the epithelial cells undergoing mitosis (cell division for those who are not up on their grade 9 biology). This creates a seal over the wound. As well, collagen is laid down which eventually leads to the formation of a very strong scar. 

6. As time goes on the scar turns from red or pink to a white colour. This is because the presence of vascular structures in the scar area decrease towards the end of the healing process.

That was easy, wasn't it? Or at least it is if you ignore the in depth insanity of the inflammatory response itself and ignore the complications that may arise during or after the healing process. That, however, is for another time and another node.

Most of this stuff was adapted from lecture notes and my textbook - Pathophysiology for the Health Professions, Fourth Edition by Barbara E. Gould and Ruthanna M. Dyer. Publisher: Saunders/Elsevier, 2011. It says not to reproduce it (as if they were the first ones to figure this s#$! out), but I altered it rather significantly and added my own clever perceptions ... okay they weren't that clever. For further interesting reading, you might want to look at the healing process surrounding burns - first, second, third which are actually more often referred to these days as partial thickness, deep partial thickness, and full thickness - maybe because it is clearer that way. 

If you are feeling disappointed right now because this node did not speak at all about healing your broken heart and/or emotional damage, perhaps you should have a cup of tea and find some hugs. Maybe read some happy stuff, okay?

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