c. Maturation. During this phase of wound healing, there is a progressive
decrease in the vascularity of the scar and an increase in the strength of the scar.
Maturation of a scar can occur up to two years after the injury took place. Ideal scarring
occurs in three stages.
Stage I--0 to 4 weeks; the scar is soft, fine, and weak.
Stage II--4 to 12 weeks; the scar is red, hard, thick, and strong.
Stage III--12 to 40 weeks; the scar is soft, supple, white, and loose.
d. Complications. Wound complication refers to anything abnormal in the
healing process. The term also refers to the loss of function of a body organ, the
function loss caused by the initial wound. Infection is the single most common wound
complication. Other complications of wound healing include bleeding, dying tissue, and
(1) Continued bleeding. Bleeding must be stopped to allow the healing
process to proceed.
(2) Dying tissue. Tissues at the site of severe injuries may have been
severely damaged by being deprived of their blood supply with its oxygen and nutrients.
These tissues will die and must be removed or carried away in the capillaries for healing
to take place properly.
(3) Results of improper healing. Here are a number of possible results of
wounds that have not healed properly.
(a) Keloid. A keloid is excessive scar tissue growth. Keloids occur
primarily in dark-skinned people. Given the proper conditions, anyone can develop a
keloid, however. It can be removed surgically for cosmetic reasons. A keloid is the
result of improper wound healing.
(b) Abscess. An abscess is a localized infection in which there is an
accumulation of pus. Pus is a liquid accumulation of phagocytes (also called
leukocytes). An infecting microorganism causes the abscess. The particular
microorganism involved determines whether the pus is white, yellow, pink, or green.
(c) Cellulitis. Cellulitis is an inflammation of the deep, subcutaneous
tissues and sometimes muscles, usually caused by infection of a wound or burn.
Cellulitis sometimes occurs when an abscess is forming. This condition is serious
because the infection can spread rapidly and extensively in the tissue spaces.
(d) Empyema. Empyema is the collection of pus in an already existing
cavity such as the gallbladder or the lung.