Based on a webinar by Jerrod Johnson, DVM, DABVP (C/F), CVPP
Wound healing is a dynamic, highly coordinated biological process. Rather than occurring as a series of isolated steps, healing progresses through overlapping phases in which cells, cytokines, growth factors, extracellular matrix components, and mechanical signals continuously interact.
Understanding these phases can help clinicians recognize where a wound is in the healing process and identify factors that may be delaying progression.
Although the phases of wound healing are often described separately, they overlap considerably. The timing of each phase can vary depending on species, wound characteristics, perfusion, contamination, systemic health, and other patient-specific factors.
| Phase | Timing | Predominant Cells | Major Events | Clinical Considerations |
|---|---|---|---|---|
| Hemostasis | Immediate to hours | Platelets | Vasoconstriction; platelet aggregation; fibrin clot; provisional matrix | Control hemorrhage; minimize hematoma, dead space, tissue injury, and additional trauma |
| Inflammation | Hours to ~3-5 days | Neutrophils → macrophages | Microbial defense; debris removal; inflammatory signaling; transition toward repair | Necrosis, infection, foreign material, ischemia, or trauma can prolong this phase |
| Proliferation | ~Day 3 to 2-4 weeks | Fibroblasts, endothelial cells, keratinocytes, myofibroblasts | Angiogenesis; granulation tissue; ECM deposition; epithelialization; contraction | Maintain moisture balance; protect granulation tissue and advancing epithelium |
| Remodeling | ~2-3 weeks to months; may continue >1 year | Fibroblasts, myofibroblasts | Collagen reorganization/cross-linking; reduced vascularity; increasing tensile strength | Closed tissue remains mechanically weaker than normal tissue and requires protection |
A wound that does not progress as expected should prompt reassessment of the wound environment. Persistent inflammation, infection, necrotic tissue, poor perfusion, pressure, or repeated trauma may interfere with normal progression.
The practical question is not only “What should I use?” but also “What does this wound biologically need next?”
Regenerative medicine approaches are increasingly focused on supporting the biological environment involved in tissue repair. Depending on the approach, regenerative products may provide or support biologically active components associated with cell signaling, extracellular matrix, and tissue repair.
The goal is not necessarily to replace the body's healing response, but to support the cellular and signaling environment in which that response occurs.
Understanding wound-healing biology helps clinicians consider:
Because wound healing is influenced by both local and systemic factors, treatment should be guided by the individual wound and patient.
Explore the full webinar with Dr. Jerrod Johnson for a deeper look at the biology of wound healing, including the cellular processes, phases of repair, and clinical considerations discussed in this article.
Watch the Full Webinar →Educational use only. This content is intended for veterinary professional education and is not a substitute for clinical judgment. Product use should be based on the individual patient and applicable product labeling.
