When recovering from breast reconstruction surgery, the initial phases of the wound-healing process are expected to take around four to six weeks. Within 3 months, the wound repair is almost as strong as it was before surgery. The entire wound healing process might take a couple of years to complete and for scars to fully mature. This time can be split into four distinct stages that are used to categorize the complex bodily processes that automatically happen during this time.
Other medical issues that also contribute to slow wound healing are diabetes, high blood pressure, obesity, vascular disease, and long-term use of certain medications. Infection, edema, insufficient nutrition, and repetitive trauma to the wound can also inhibit wound healing.
Stage 3: Proliferative Stage
During the proliferative stage, the body begins to rebuild, shrink, and cover the wound. This area is repaired with new tissue made of collagen, elastic fibers, sugars, and proteins produced by fibroblasts (the most common type of cell in connective tissue).
Fibroblasts also secrete and regulate the extracellular matrix (ECM), a molecular network needed to support the structure of connective tissue and control most cellular functions, including cell adhesion, growth, metabolism, migration, and differentiation.
As new tissue is formed, some of the fibroblasts become myofibroblasts. These cells are largely responsible for wound closure, working to grasp the margins of the wound and pull them together.
A new network of blood vessels is constructed to supply oxygen and nutrients to granulation tissue (tissue made up of new connective tissue and blood vessels). This tissue fills in the area, beginning at the base of the wound.
Healthy granulation tissue is pink/red, has an uneven texture, and doesn’t bleed very easily. Dark, smooth granulation tissue that bleeds easily could be a sign of issues, such as infection or inadequate blood flow.
Epithelial cells make up the outer layer of tissue, and during epithelialization, these cells multiply. The cells adjacent to the wound move toward the area, connecting with each other and forming a new outer layer of tissue.
Rebuilding a wound takes time, so the proliferative stage can last for weeks (much longer than the previous two stages). Keeping the wound area hydrated and taking care of your dressings properly facilitates this process and helps promote quicker, safer healing.