The wound healing process is a lengthy one. On the surface, a wound may appear healed within the first few weeks, but deep underneath, the healing process continues. The deeper and wider the wound is, the longer the healing process takes. Over time, several issues may be noticed with a healing wound.
1. Color and pigmentation: Over time, the skin color gradually normalizes and the pigmentation returns to skin. With deep scars, the pigmentation and color may not totally normalize and the scar tissue will have an appearance that will be different from the surrounding skin.
2. Overall Appearance: Within the first few weeks, the appearance of the wound changes almost daily. As the healing continues, the appearance gradually improves. Redness may persist at the line of the wound for several weeks to months. This is due to the inflammatory response of the skin. The skin color and appearance constantly changes for as long as there is inflammation. Superficial wounds will normally heal completely and leave no marks; however, deep wounds, cuts and surgical wounds, almost always leave a mark.
3- Strength: Deep wounds, such as surgical incisions, result in total disintegration of the fabric of the normal skin. The healing process, although it closes the gap in the skin and makes the surface flat, can not give the skin its full normal strength. The scar tissue, as strong as it may be, does not provide the same strength to skin. This minor weakness in the wound may never result in any noticeable problems though.
4- Complications: Along the way, an individual may encounter certain complications that can interfere with the healing process, as well as the esthetic outcome of the wound.
a. Wound infection will delay the healing process, along with the appearance and strength of the scar.
b. Wound dehiscence is another issue that may be encountered during the first few weeks of wound healing. The wound may simply reopen. Wound dehiscence will result in poor wound healing and a wider scar down the road. Stretching of the wound, especially in chest wounds or near the joints, shoulders, etc. can result in widening of the scar. Infections and certain medical conditions such as diabetes and poor nutrition are a few factors that can result in wound dehiscence.