When you think about a wound, what comes to mind? Maybe it’s your child’s scraped knee or a cut from a kitchen incident. Wounds can also be the result of an incision made during surgery or a symptom of a condition such as diabetes.
When a wound happens, your body leaps into action to heal itself and is usually able to make everything right again. That’s why your kiddo’s scraped knee looks better within a few days and surgical incisions can heal in a matter of weeks. But sometimes wounds stick around longer than they should, and in some cases, they can become chronic wounds.
So, how do you know if your wound is healing properly? And how can you tell if a wound is infected and may need medical attention? Read on to learn about the stages of wound healing and what to do when you have a wound that’s not healing the way it should.
The stages of wound healing: How to tell if you’re on track
No matter how a wound came about, the stages of healing are the same. Below, we’ll cover how your body stops the bleeding, cleans and protects the wound, and builds and strengthens new skin. We’ll also explain approximately how long each stage should take.
Hemostasis is the first stage of wound healing. Your body’s goal during this stage is to stop the bleeding.
What your body does: Closes the wound by forming a clot to stop blood from leaking out of your body. Here’s what happens:
- Step 1: The blood vessels around the wound narrow. This decreases the amount of blood flowing to the wound.
- Step 2: Your platelets, the part of your blood that is involved in clotting, stick together and seal up the breaks in your blood vessel walls.
- Step 3: During the clotting process, the platelets meet with elastic tissues called collagen and an enzyme called thrombin. This makes your blood thicker, like a gel.
How long it takes: This stage of wound healing happens pretty quickly – usually within a few minutes.
Signs it’s working: You know that you’ve made it through the hemostasis stage if your wound has stopped bleeding.
The inflammatory stage is the second stage of wound healing. The goal of this stage is to clean and stabilize the wound.
What your body does: Gets rid of the bacteria and debris that could prevent proper wound healing while also creating a barrier against infection. Here’s what happens:
- Step 1: A type of white blood cell, called neutrophils, arrives on the scene to destroy germs that could have gotten in your wound when you cut or scraped yourself. Most of their work happens within 24-48 hours of your injury.
- Step 2: When the white blood cells leave, they are replaced by macrophages, specialized cells that continue to defend and clean your wound. The macrophages also release chemicals that send a signal to your immune system cells to help with the repairs.
How long it takes: Usually about 4-6 days.
Signs it’s working: During this stage of healing, you may experience swelling, redness or pain while your wound heals. Your skin may also feel hot to the touch, and you may see a clear liquid around your wound. These are all signs that the inflammatory stage of wound healing is well underway.
Inflammation is important to wound healing because it helps control the bleeding and prevent infection. But if you continue to experience inflammation for more than a couple weeks, it may be a sign that something is getting in the way of the healing process and you should talk to a doctor. We’ll get into possible reasons for poor healing below.
The third stage of wound healing is the proliferative stage and that’s when the rebuilding process begins. Proliferative means that your cells are multiplying and spreading – and that’s a good thing because your body uses these cells to repair your wound.
What your body does: Fills, defines and covers up the wound with new tissue. Here’s what happens:
- Step 1: This stage starts with filling in the wound with lots of new cells, forming new tissue. These new tissues, known as granulation tissues, are usually pink or red and uneven in texture. Your body also forms new blood vessels so that the new tissue receives enough oxygen and nutrients.
- Step 2: Your body defines what will be the outside edge of your wound. This happens naturally as the new granulation tissues form, pulling the edges of the wound together.
- Step 3: The last part of the proliferative stage involves layering the wound with epithelial cells, which are the type of skin cells that cover the surface of your body.
How long it takes: Usually between 4-24 days. You can help the healing process stay on track by keeping the new tissue on wounds clean and hydrated.
Signs it’s working: During this stage, the granulation tissue over your wound is typically pink or red and uneven in texture – and it usually doesn’t bleed. However, if the new tissue is very dark, that could be a sign that things aren’t healing the way they should, and you may need to talk to a doctor.
The last stage of wound healing is the maturation stage, sometimes called the remodeling stage. The goal of this stage is to strengthen the repair. Even if your wound is closed and looks healed at the end of the proliferative stage, it takes time for the skin to become strong and more flexible.
What your body does: Organizes cells and strengthens the new tissue. Here’s what happens:
- Step 1: Your body will remove cells that are no longer needed in the healing process.
- Step 2: Through a process called cross-linking, the tissues become stronger and your scar likely gets thinner at this point. But even with cross-linking, healed wounds are not as strong as they used to be – healed skin generally only has 80% of the strength of uninjured skin.
How long it takes: Anywhere from three weeks to two years, depending on some of the factors listed below.
Signs it’s working: At the beginning of the maturation stage, the new tissue may look pink, wrinkled or stretched. But as time goes on, the tissue will fade in color and flatten out. However, you may always have a scar.
Common signs of wound healing problems
We’ve talked about signs of good healing. So, what are signs that a wound is not healing the way it should? Here are some things to watch for:
An infection can slow the pace of healing. That’s because your body is putting all its effort into trying to keep your wound clean and getting rid of the bacteria, fungi or germs that are in the wound.
If you think you have an infection, talk to a doctor right away, no matter how small your wound is. This will help reduce the chance of the infection spreading. The following are ways to tell if your wound may be infected:
- Swelling and redness
- Tenderness or pain, especially if it’s getting worse or spreading
- A wound that’s hot to the touch
- Pus or liquid oozing from the wound
- Darkening of the skin at the edges of the wound
- A wound that smells bad
Inflammation that doesn’t go away
While inflammation is an important part of wound healing, prolonged or returning inflammation can signal that there’s a problem such as poor healing or infection. While it can take up to a year or more for a wound to fully heal, it should start looking better after about a week. At this point the inflammation should be mostly gone and your body should be working on making new tissue. If your wound is still red and raw after a couple weeks, it’s a good idea to talk to a doctor – even if you don’t think you have an infection.
Are some people more likely to have get slow healing wounds?
Yes. Slow-healing wounds are more common if you have diabetes, kidney disease, obesity, high blood pressure or vascular disease. Here’s how these conditions affect your body’s ability to heal itself:
- Poor circulation – Your body may be slower to move oxygen-rich blood throughout your body, which means that wound sites may not get the oxygen-rich blood needed to promote healing.
- Weakened immune system – Your immune system may not work as well, making you less able to fight off infections.
- Increased inflammation – Your body’s cells may also have increased inflammation, making it harder for your body to control inflammation in your wound.
Having one or more of these conditions doesn’t mean that your wounds won’t heal. However, you’ll want to watch out for new wounds to make sure they don’t turn into chronic wounds.
What is a chronic wound?
A wound becomes chronic when it heals very slowly or doesn’t heal at all. The following may be signs that a wound is chronic:
- You’ve had the wound more than four weeks.
- Your wound has not moved out of the inflammation stage. For example, you may have a wound that scabs over again and again, but your body never gets to the point of rebuilding new skin.
- Within the last month, there’s been no new signs of healing. For example, the wound hasn’t formed new scabs or tissue.
Wounds don’t need to be large to become chronic. If there’s a small scratch that doesn’t heal, that can be an issue, too. So, pay attention to all your cuts and scrapes, no matter how tiny.
Although chronic wounds are most common in people with diabetes, kidney disease, obesity, high blood pressure or vascular disease, you can have a chronic wound even if you are otherwise healthy.
How to make a wound heal faster
Take good care of your wounds
Your wound may heal faster if you keep it clean, moist and free of bacteria. Using antibiotic cream and keeping it covered with a bandage can help.
If your wound is large or deep, it may take longer to heal. And if you have lots of tissue damage, your body may need more time to fully recover. Larger or deeper wounds heal faster when treated by your doctor. When your doctor closes a wound using stitches, it reduces the area that your body needs to work at healing.
Eat a wound healing diet
Your body needs certain nutrients to fix your wounds. To have a wound healing diet, make sure you’re getting enough of the following:
Usually you can get enough of the nutrients you need by eating a balanced diet that includes lots of fruits and vegetables. But talk to your doctor if you have questions.
Get help for infected and slow-healing wounds
Your body has an amazing ability to repair all your cuts and scrapes. For most people, it’s just a matter of time before things heal.
But if you think your wound is taking too long to heal or may be infected, it’s time to talk to a doctor. This is especially true if you have medical conditions that can slow wound healing.
If you have a wound that won’t heal, we can help
We can help you get the wound healing process back on track. Even if you’ve had a chronic wound for months or years, it’s not too late to get treatment. Our Wound Healing Center offers the most advanced options for the most chronic wounds.