Physiology and healing
Inflammation, haemostasis, bone turnover and wound healing underpin routine care. Medical disease and medicines can change each stage.
Understand
Haemostasis, inflammation, proliferation and remodelling overlap during healing. Bone is continuously remodelled; oxygenation, nutrition, perfusion, infection control and medication exposure influence repair.
Assess
When a wound is slow to heal, review the local cause, infection, trauma, vascularity, systemic disease and drugs. Assess whether apparent inflammation is expected or progressive.
Apply
Plan atraumatic treatment and clear review. Persistent non-healing, disproportionate pain or exposed bone requires reassessment rather than repeated empirical treatment without a diagnosis.
Key distinctions
Inflammation is necessary for repair but persistent contamination or mechanical trauma can prevent progression to granulation and epithelial closure. Bone healing involves both osteoclastic resorption and osteoblastic deposition; radiographic change lags behind biological activity. Consider how smoking, diabetes control, nutrition and antiresorptive treatment affect prognosis without assigning a single cause automatically.
Think through a case
A socket still shows exposed bone and increasing pain weeks after extraction. Compare the expected healing sequence with infection, trauma, medication exposure and pathology before repeating a dressing.
The distinction to remember
Do not label every red wound “infected”. Healing tissue can be inflamed; duration, progression and systemic findings decide whether the course is abnormal.
Test your recall
What are the broad phases of wound healing?
Show answer
Haemostasis and inflammation, proliferation, then remodelling.