The 4 Stages of a Healing Wound & the Vital Role of Collagen
Whether you’ve just suffered an injury or are undergoing surgery, you probably want to understand the stages of a healing wound and how long your recovery should take. After all, you want to understand if your healing is going smoothly or not.
Learning the four stages of healing wounds will help you understand how the body repairs itself. It will help you manage wound healing after surgery and keep you on the right track to full recovery.
In this article, we'll explain each stage of wound healing and all the signs of a healing wound. You'll also learn the factors that can affect wound healing both positively and negatively - so you can ensure your healing process is as swift as possible.
The 4 stages of a healing wound
While a larger wound will take longer to heal than a minor cut, no matter the size or severity of our wounds, we all go through the same stages of healing. So let’s look at the four distinct stages of healing wounds, and the important role collagen plays in the process.
Stage 1: Hemostasis
Hemostasis is your body's immediate reaction to an open wound. It is significant in wound healing as it helps stop the bleeding and prevent total blood loss.
By stopping the bleeding, the hemostasis stage starts to repair damage and prevent infection. Hemostasis, itself, involves a collection of several processes:
First, the body sends blood platelets to the damaged area. These platelets begin to stick to the damaged tissue. The body will generate enough platelets to clot the blood and prevent further blood loss. This clot helps to trap blood in and prevent germs and other pollutants from entering the open wound.
However, the platelet plug alone won’t protect your wound site. The plug needs help to stay in place to ensure that the clot doesn't break.
This is why coagulation occurs.
What is coagulation? It is the process of blood (or any liquid) changing to a solid- or semi-solid state.
Coagulation occurs when a sequence of proteins, mainly produced in your liver, is activated. These proteins are often called “blood clotting factors.” These blood clotting factors interact in a series of chemical reactions to create long strands of fibrin.
Fibrin is stronger than your blood platelets, and forms a sort of mesh net that traps the platelets and blood cells, reinforcing the platelet plug. The fibrin will continue to build and build until the wound site is safely plugged.
The hemostasis process begins about 20 seconds after an injury or incision and can take anywhere from 4 to 10 minutes to complete. (Of course, it can take longer in individuals with blood clotting issues.)
Poor blood clots may result from underlying health conditions such as leukemia or genetic disorders, which may require further medical attention.
Hemostasis sets the stage for the other three stages of a healing wound and prevents the risk of further health complications. Once your wound has properly clotted, your body will move into the next stage of wound healing: the inflammatory stage.
Stage 2: Inflammation
The second stage of wound healing is the inflammatory stage. Inflammation takes longer than hemostasis, and it may last from 24 hours to 7 days or more.
The inflammatory response is often characterized by swelling, redness, heat, and pain around the wound site. You might think that inflammation is a bad thing, but it actually is important to the wound healing process.
Inflammation allows increased movement of cells to the wound site. The three primary cells that are active in the inflammatory phase are neutrophils, monocytes, and macrophages.
These cells assist in killing bacteria, firming up the cell walls for added protection, and removing damaged tissue from the wound site. After the inflammation stage, the healing and repair of the damaged tissue can fully occur.
Of course, most cases of a wound not healing are from wounds that are stuck in this inflammatory stage. There can be various causes of this, which we will discuss later in this article.
If you notice that your inflammation hasn’t gone away after 5-7 days, or has returned later on, it’s important to reach out to a doctor to ensure you can complete the proper stages of a healing wound.
Stage 3: Proliferation
Once the redness and swelling have stopped, the injury has entered the rebuilding stages of healing wounds. The first of these is the proliferation stage. The proliferation stage starts with a process called angiogenesis, which involves the formation of new blood vessels allowing for tissue growth.
You may be wondering, where does collagen begin to factor into all of this?
The new tissue that is laid down during the proliferation stage is called granulation tissue, and this network of new tissue is created by collagen protein! So, if you don’t have enough collagen protein, you won’t be able to create new tissue very effectively to fill in your wound.
Granulation tissue is characterized by its reddish or pink color and uneven texture. It is rougher than normal skin tissue, and not laid down in an even manner, because your body is simply filling in the wound site as quickly and efficiently as possible.
During this stage of wound healing, the clot will dry into a scab and the wound will start pulling in at the edges to become smaller and smaller.
The proliferation phase typically lasts about four days to 24 days, but may last even longer depending on the seriousness of the injury and your body’s natural healing potential. Once your wound is fully filled in with granulation tissue, you will move on to the last stage of a healing wound.
Stage 4: Remodeling
The remodeling stage is also known as the maturation phase, which is the final step in the healing stages of wounds. Typically, the remodeling stage lasts two years or more after the contraction of the wound.
Although collagen is essential throughout the wound healing process, the protein is highly utilized in this final phase.
During the remodeling phase, cellular activity and the number of blood vessels in the wounded area decreases. Here collagen production is prioritized to regain strength, resistance, and skin elasticity.
It involves remodeling the collagen, which swaps out the type III collagen used in the granulation tissue for a stronger, smoother type I collagen. The collagen fibers cross-link, reducing the thickness of the scar and making the injury site stronger.
This process is more slow and methodical as opposed to the swift slap down of tissue in the proliferation stage. That’s because instead of simply filling in the wound site, your body is trying to replace the granulation tissue with strong tissue that will actually last.
This being said, even after your wound is fully healed, it will only gain back 80% of the tensile strength of the original uninjured skin. This means you will always be more prone to reinjury, especially if you have poor nutrition or depleted collagen stores.
This is where it’s important to note that our natural collagen stores start to dwindle in our mid-twenties and decrease each year.
That’s why a collagen supplement might be necessary for swift wound healing - your body might not be able to go through all the stages of a wound healing easily without additional collagen. Of course, collagen levels aren’t the only factor that can affect how well you can heal.
Factors that may affect wound healing
Suppose you’ve noticed your wound not healing and you're concerned. If so, it’s important to understand specific factors that can delay the stages of a healing wound. Here are some of those factors, as well as what to do if a wound won't heal.
Age
Age is one of the significant factors that can affect the healing capacity of humans. Studies have shown that middle-aged adults from 60 years and older experience delayed stages of a healing wound. If you are older and having trouble with wound healing, ask your doctor if there are safe ways to boost your wound-healing potential.
Nutrition
Good nutrition is essential for wound care to ensure the body has enough resources for the stages of healing wounds. The body requires a high amount of protein and calories for wound repair, and protein deficiency can deplete the body's ability to heal.
You may also need supplements and multivitamins on top of a healthy diet in order to boost your immune system.
Wound type
Generally, the type of wound will determine the length of the healing stages of wounds. A small cut will take about three days to a week to completely heal, while a severe trauma can last months or up to a year.
In addition, the shape and depth of the injury can also affect the healing process. Of course, there are still many methods you can try for how to heal deep wounds faster.
Underlying health conditions
If you have a chronic health issue like diabetes, then you're probably wondering, Does diabetes slow wound healing? Unfortunately, the answer is yes. People with diabetes tend to have more trouble moving through the stages of a healing wound, as do people with heart disease and other cardiovascular conditions.
Skin moisture
The skin needs enough moisture and fluid to heal properly. People with extremely dry or wet skin may experience thickening, skin lesions, and infection, which can delay the healing stages of wounds.
Obesity
Excess body fat and extreme weight gain are major health issues that impair wound healing. Increased body fat leads to poor blood circulation, eventually slowing the wound healing process.
Medication
Prescription medications, including NSAIDs such as ibuprofen and aspirin, have been shown to slow down the stages of a healing wound. Anticoagulants can also disrupt blood clotting and enhance the risk of infection.
Importance of collagen in wound healing
While there may be many factors that could slow down the stages of healing wounds, collagen supplementation is one that can speed them up.
Collagen is the most abundant protein in the body, and it plays a vital role in the stages of healing wounds. It has a chemotactic nature which draws fibroblasts to the wound site, which helps coagulation. It also allows generation of new tissues in the third and fourth stages of healing wounds.
By now, you should have a crystal clear understanding of the four stages of a healing wound and collagen's role in them. The last question you likely have is, “What kind of collagen should I use to aid in my wound healing process?”
The best collagen for wound healing
Not all collagen supplements are created equal. That being said, many doctors administer collagen supplements to stimulate healing. It is common for patients with protein deficiency to use collagen supplements and other immune system aids to hasten the wound healing process.
So what kind of collagen are they using? Most likely, a medical-grade collagen. Medical-grade collagen is collagen that is regulated by the FDA and overseen by medical professionals - in other words, it's absolutely safe to use for wound healing.
In contrast, most collagen supplements are NOT FDA regulated, so companies can put any number of sweeteners or additives in their product. Especially when dealing with wound healing, you don’t want any unpleasant surprises - so it’s best to find a trusted source for your supplement.
That’s why we recommend the medical-grade collagen from ProT Gold when trying to speed up the stages of a healing wound. ProT Gold collagen is nano-hydrolyzed, so you can achieve full absorption in just 15 minutes or less.
Because it’s medical-grade, ProT Gold has been chosen for use in medical nutrition by thousands of medical facilities in the United States. If you’re looking for a trusted way to speed up the stages of a healing wound, this simple supplement could make a big difference.
