An abrasion is superficial damage to the skin caused by contact with a rough surface. The top layer of the skin is damaged. At the site of the defect, serous exudate with a small admixture of blood is present. Although the injury is shallow, abrasions are very painful and sometimes difficult to heal, which is often due to contamination remaining in the wound after the injury. They can become the cause of a serious infection. It is important to treat them properly. The management of minor epidermal abrasions is presented below
Usually these measures and proper care are sufficient for self-healing of the wound within a few days. Unfortunately, sometimes even small and inconspicuous injuries can be very difficult to heal. It is always worth paying attention to whether the patient is at risk for a poorly healing wound. Attention should be paid to the possibility of infection as evidenced by the appearance of redness, skin warming, swelling, pain, and discharge/pus. If these symptoms occur, it is important to see a doctor or go to the emergency room if a tetanus vaccine needs to be administered, the wound edges need to be sutured, or a foreign body needs to be removed from the wound.
The wound healing process involves complex chemical reactions of locally active, biologically active substances and physical phenomena that include changes in skin elasticity and increased tensile strength. Three basic stages of wound healing can be distinguished:
In the exudative phase, a local inflammatory reaction occurs, which usually lasts 4-7 days and is characterized by exudation and swelling. In normal healing wounds the exudate takes on a light, yellow-pink color. The presence of exudate positively influences the wound healing process. Inflammatory cells (neutrophils, monocytes, lymphocytes) appear, protecting the defect from contamination and pathogenic microorganisms. In the cleansing phase, there is an increased number of macrophages that eliminate incoming dirt and bacteria. Proper wound healing occurs in the proliferative phase lasting 3 to 6 weeks, where fibroblasts from adjacent tissues are activated and vascularization occurs.
Fibroblasts have the ability to produce proteolytic enzymes that support tissue regeneration and produce collagen fibers which are the basis for building and regenerating connective tissue, rebuilding damaged blood vessels and creating a scar at the site of injury. Thanks to this phase, the wound shrinks and epithelialization occurs. The final stage of wound healing is wound remodeling, in which collagen remodeling occurs from 3 weeks to several years.