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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