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Topic: Current Concepts in Wound Healing




          Assessment of the histological state of the


          healing wound




          Akriti Gupta , Pramod Kumar      2
                        1
          1 Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai 400012, Maharashtra, India.
          2 Department of Plastic Surgery, King Abdulaziz Specialist Hospital, Sakaka 42421, Al-Jouf, Saudi Arabia.
          Address for correspondence: Dr. Akriti Gupta, Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai 400012,
          Maharashtra, India. E‑mail: dr.akriti@gmail.com

                ABSTRACT
                The dynamic process of wound healing has various phases, and the knowledge of which is essential
                for identification of the pathology involved in a chronic intractable wound. Various instruments for
                the assessment of wound healing have been described, primarily for clinical assessment of the wound.
                However, very few instruments are currently available for histological grading of the wound. The aim
                of this article is to review all available literature from 1993 to 2014 on the objective histological scoring
                of the state of wound healing. This review article emphasizes the importance of histological grading of
                wounds based on the different parameters from each phase of wound healing and the need for an ideal
                grading system in order to help assessment of wound status. The parameter chosen in an experimental
                model should be defined by the scientific question, the underlying hypothesis and the pathogenesis of
                the disease.
                Key words:
                Experimental wound assessment, grading  of wound, histopathologic grading, wound assessment,
                wound grading, wound healing, wound histology

          INTRODUCTION                                        Impaired wound healing is not an uncommon occurrence
                                                              in  clinical practice. Both local and systemic  factors
          The  dynamics  of  wound  healing  are  complex.  A  thorough   are responsible for impaired healing and  weak scar
          understanding  of  the  normal  healing  process  is  a   tissue formation.  Acute wounds  heal following  the
                                                                             [2]
          prerequisite for unveiling the pathology. Wound healing   normal  sequence  of  the  healing  process.  Acute  wounds
          begins  with  homeostasis  at the  site  of injury,  progresses   that fail to progress in a timely  and orderly fashion
          to an inflammatory phase followed by proliferation of   through the  normal  stages  of healing  are  described as
          the epithelial and matrix components, and ends with the   chronic wounds.   Because of  associated early  and late
                                                                            [1]
          formation of scar tissue marked by laying down of a highly   complications, chronic wounds remain  an intractable
                                  [1]
          organized collagen matrix.  Various factors, extrinsic   clinical  problem and a frequent cause of morbidity and
          and intrinsic to the injured tissue, affect the healing   mortality. [1]
                 [2]
          process.  These are broadly categorized into local and   Various  interventions  are  available  for amelioration  of
          systemic factors. Factors directly influencing the immediate   impaired healing. Hence, it is important to evaluate
          wound environment are considered to be local factors,   wound healing in order to compare the efficacy of
          while  the  overall  health  of  the  individual  affecting  his
                                                [3]
          ability to heal constitutes the systemic factors  [Table 1].
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                                                               How to cite this article: Gupta A, Kumar P. Assessment of the
                                   DOI:                        histological state of the healing wound. Plast Aesthet Res 2015;2:239-42.
                                   10.4103/2347-9264.158862
                                                               Received: 29-12-2014; Accepted: 18-03-2015

          © 2015 Plastic and Aesthetic Research | Published by Wolters Kluwer - Medknow                     239
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