ABSTRACT:
Wound healing is a complex, dynamic, and highly regulated biological process essential for restoring the structural and functional integrity of damaged skin. It begins immediately after injury and involves a coordinated sequence of overlapping phases, namely hemostasis, inflammation, proliferation, and remodeling. Depending on the duration and progression through these stages, wounds are classified as acute or chronic. Acute wounds typically heal in an orderly manner, whereas chronic wounds result from disruptions in one or more healing phases and are commonly associated with underlying conditions such as diabetes mellitus, vascular insufficiency, immunologic disorders, and pressure-related injuries. Multiple local and systemic factors—including oxygenation, infection, age, nutrition, obesity, medications, and psychological stress—significantly influence the healing outcome. Impaired wound healing is characterized by prolonged inflammation, reduced angiogenesis, excessive protease activity, and delayed re-epithelialization. Accurate diagnosis of wound status and infection involves clinical assessment, laboratory markers, and advanced imaging modalities. Effective wound management requires a multidisciplinary approach incorporating wound cleaning, infection control, appropriate dressings, surgical intervention when necessary, and management of contributing systemic conditions. Advances in diagnostic and therapeutic strategies continue to enhance clinical outcomes and reduce the global burden of chronic wounds.
Cite this article:
Bhoi Neha Sunil, Javesh. K. Patil, Sunil. P. Pawar. A Comprehensive Review of Wound Healing: Phases, Types and Influencing Factors. Research Journal of Pharmacology and Pharmacodynamics.2026;18(3):277-1. doi: 10.52711/2321-5836.2026.00037
Cite(Electronic):
Bhoi Neha Sunil, Javesh. K. Patil, Sunil. P. Pawar. A Comprehensive Review of Wound Healing: Phases, Types and Influencing Factors. Research Journal of Pharmacology and Pharmacodynamics.2026;18(3):277-1. doi: 10.52711/2321-5836.2026.00037 Available on: https://www.rjppd.org/AbstractView.aspx?PID=2026-18-3-8
REFERENCES:
1. Heng MC. Wound healing in adult skin: aiming for perfect regeneration. Int J Dermatol. 2011 Sep; 50(9): 1058-66.
2. Reinke JM, Sorg H. Wound repair and regeneration. Eur Surg Res. 2012; 49(1):35-43.
3. Sim SL, Kumari S, Kaur S, Khosrotehrani K. Macrophages in Skin Wounds: Functions and Therapeutic Potential. Biomolecules. 2022 Nov 08;12(11)
4. Cullen B, Smith R, McCulloch E, Silcock D, Morrison L. Mechanism of action of PROMOGRAN, a protease modulating matrix, for the treatment of diabetic foot ulcers. Wound Repair Regen. 2002 Jan-Feb;10(1):16-25.
5. Wallace HA, Basehore BM, Zito PM (2023). "Wound Healing Phases". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 29262065. Retrieved 19 January 2024.
6. Raziyeva K, Kim Y, Zharkinbekov Z, Kassymbek K, Jimi S, Saparov A. Immunology of Acute and Chronic Wound Healing. Biomolecules. 2021; 11(5): 700. doi:10.3390/biom11050700. Cuts and puncture wounds. MedlinePlus Medical Encyclopedia. U.S. National Library of Medicine. Retrieved 8 November 2023
7. Ibrahim DA, Swenson A, Sassoon A, Fernando ND. Classifications In Brief: The Tscherne Classification of Soft Tissue Injury. Clinical Orthopaedics and Related Research. 2017; 475(2): 560–564. doi:10.1007/s11999-016-4980-3.
8. Nagle SM, Stevens KA, Wilbraham SC (2023). "Wound Assessment". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 29489199. Retrieved 12 January 2024.
9. Star A. Differentiating Lower Extremity Wounds: Arterial, Venous, Neurotrophic. Seminars in Interventional Radiology. 2018; 35(5): 399–405. doi:10.1055/s-0038-1676362.
10. Burgess JL, Wyant WA, Abdo Abujamra B, Kirsner RS, Jozic I. Diabetic Wound-Healing Science. Medicina. 2021; 57(10): 1072. doi:10.3390/medicina57101072. PMC 8539411. PMID 34684109.
11. Star A. Differentiating Lower Extremity Wounds: Arterial, Venous, Neurotrophic. Seminars in Interventional Radiology. 2018; 35(5): 399–405. doi:10.1055/s-0038-1676362. PMC 6363550. PMID 30728656.
12. Burgess JL, Wyant WA, Abdo Abujamra B, Kirsner RS, Jozic I. Diabetic Wound-Healing Science. Medicina. 2021; 57(10): 1072. doi:10.3390/medicina57101072.
13. Robles-Tenorio A, Lev-Tov H, Ocampo-Candiani J (2023). "Venous Leg Ulcer". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 33620871.
14. ReZemaitis MR, Boll JM, Dreyer MA (2023). "Peripheral Arterial Disease". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 28613496. Retrieved 19 January 2024.trieved 19 January 2024.
15. Avishai E, Yeghiazaryan K, Golubnitschaja O. Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine. The EPMA Journal. 2017; 8(1): 23–33. doi:10.1007/s13167-017-0081-y.
16. Zaidi SR, Sharma S (2023). Pressure Ulcer. StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 31971747. Retrieved 19 January 2024.
17. Shaw TJ, Martin P. Wound repair at a glance. J Cell Sci. 2009; 122: 3209-13.
18. Medrado AR, Pugliese LS, Reis SR, Andrade ZA. Influence of low-level laser therapy on wound healing and its biological action upon myofibroblasts. Lasers Surg Med. 2003; 32: 239-44.
19. https://share.google/FfrbHdUpJeYFlv0kz.
20. Li J, Chen J, Kirsner R. Pathophisiology of acute wound healing. Clin Dermatol. 2007; 25: 9-18
21. Rosen BP. Biocemistry of arsenic detoxification. FEBS Lett. 2002; 529: 86-92.
22. Armulik A, Genové G, Betsholtz C. Pericytes: Developmental, Physiological and Pathological Perspectives, Problems and Promises. Dev Cell. 2011; 21: 193-215.
23. Xian X, Håkansson J, Ståhlberg A, Lindblom P, Betsholtz C, Gerhardt H, et al. Pericytes limit tumor cell metastasis. J Clin Invest. 2006; 116: 642-51
24. Takakura N. Role of hematopoietic lineage cells as accessory components in blood vessel formation. Cancer Sci. 2006; 97: 568-74.
25. Witte MB, Barbul A: General principles of wound healing. Surg Clin North Am 1997; 77: 509– 528
26. Ramasastry SS: Acute wounds. Clin Plast Surg. 2005; 32: 195– 208.
27. RobsonMC, Steed DL, Franz MG: Wound healing: biologic features andapproaches to maximizehealing trajectories. Curr Probl Surg. 2001; 38: 72–140.
28. Sieggreen MY: Healing of physical wounds. Nurs Clin North Am. 1987; 22: 439– 447.42– 48.
29. Clark RA: Regulation of fibroplasia in cutaneous wound repair. Am J Med Sci. 1993; 306: 42– 48.
30. Pierce GF, Vande Berg J, Rudolph R, et al: Platelet-derived growth factor-BB and transforming growth factor beta 1 selectively modulate glycosaminoglycans, collagen, and myofibroblasts in excisional wounds. Am J Pathol. 1991; 138: 629– 646.
31. Avishai E et al. Imapired wound healing: facts and hypothesis for multi-professional considerations in predictive, preventive and personalized medicine, EPMA Journal. 2017; 8: 23-33.
32. Van Asten SA, Jupiter DC, Mithani M, La Fontaine J, Davis KE, Lavery LA. Erythrocyte sedimentation rate and C-reactive protein to monitor treatment outcomes in diabetic foot osteomyelitis. Int Wound J. 2017; 14: 142–148.
33. Spoto S, Valeriani E, Caputo D, et al. The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery: advantage from daily measurement. Medicine (Baltimore). 2018; 97: e9496.
34. Järbrink K, Ni G, Sönnergren H, et al. The humanistic and economic burden of chronic wounds: a protocol for a systematic review. Syst Rev. 2017; 6:15.
35. Xia D, Samols D. Transgenic mice expressing rabbit C-reactive protein are resistant to endotoxemia. Proc Natl Acad Sci USA. 1997; 94: 2575–2580
36. Menke NB, Ward KR, Witten TM, Bonchev DG, Diegelmann RF (2007). Impaired wound healing. Clin Dermatol. 25:19-25.