The Four-Stage Process of Wound Healing

Reviewed by Christine Kijek, Registered Colorectal Nurse  on, June 16, 2022

Haemostasis Phase      |    Inflammatory Phase      |    Proliferative Phase      |    Maturation Phase

Wound healing is a natural restorative response to tissue injury. There are many types of wounds and they require different wound care products for proper recovery but most go through similar healing stages. It is essential to remember that wounds can progress both forward and back through the phases.

The Four-Stage Process of Wound Healing

What are the stages of Wound Healing?

As the body engages in wound healing, a biochemical process takes place throughout body systems. It traditionally can be explained in terms of 4 classic phases:

Hemostasis Phase

This refers to the process that stops the actual bleeding. The Hemostasis stage is a very quick process. It begins when blood starts leaking out of the body. In response, the blood vessels constrict to limit the blood flow. Blood platelets attach together to seal the break in the blood vessel. Later, clotting occurs and toughens the platelet with fibrin which is considered a molecular binding agent. The formation of a thrombus or clot keeps the platelets and blood cells trapped in the wound area. The thrombus is important in the process of wound healing but can cause trouble if it detaches from the vessel wall and enters the circulatory system. This might lead to the possibility of a stroke, pulmonary embolism, or heart attack.

Most of the time, your body will attain this through a process called vasoconstriction, where the blood vessels are closed tight. Once hemostasis is achieved the blood vessels expand, letting white blood cells, antibodies, nutrients, enzymes, and other elements flow properly into the affected area to advance wound healing and fight against infection. This is the time when someone would experience physical changes in inflammation i.e., pain, swelling, redness, and heat.

Sometimes, it is advisable to use hemostatic agents such as powders, gels, or pads that speed the process of hemostasis. Hemostatic bandages and hemostatic gauze are some of the most recommended agents used to aid this stage.


Inflammatory Phase

Inflammation is a way that the body uses to alert you to an injury. It is vital in the wound care process, but if it goes on for too long, it can hinder regeneration. The process initiates right after the injury when the injured blood vessels leak transudate which is a fluid made of salt, protein, and water that causes swelling. Inflammation controls bleeding as well as prevents the wounded area from infection. Meanwhile, the healing and repair cells rush to the site of the wound where fluid is accumulated.

In this stage, bacteria, damaged cells, and pathogens are removed from the wounded area. The white blood cells, nutrients, and enzymes create the swelling, pain, heat, and redness that are seen during this stage of healing.

Inflammation is only problematic if the phase is prolonged. If the inflammation increases beyond the standard time or is painful, one can use anti-inflammatory agents such as gels, pads, powders, creams, etc.

Proliferative Phase

In the proliferative phase of wound healing, the wound is rebuilt with new granulation tissue made up of collagen and extracellular matrix. The proliferative phase contracts the wound as new tissues are built. Along with this, new blood vessels are also constructed to ensure granulation tissues stay healthy and get vital oxygen and nutrients.

The wound is contracted by Myofibroblasts that grip the wound edges and pull them together. Granulation tissue generally stays pink or red and has an uneven texture. Furthermore, granulation tissue does not bleed easily. Monitor the color, as dark granulation tissue can be a sign of infection. In the last phase, the injury is covered with epithelial cells. It is important to remember that when wounds are kept moist the epithelialization happens faster than normal. Apply occlusive or semi- occlusive dressings within 48 hours after injury; they will maintain optimum tissue moisture for effective epithelialization.

Maturation Phase

Maturation, also known as remodeling, is the last stage of the wound healing process and occurs after the wound is closed. It may take up to 2 years. The cells that had been used to repair the wound are no longer needed and are removed by apoptosis or programmed cell death.

During the maturation phase, collagen aligns along tension lines and water is absorbed so the collagen fibers can lie closer together. Cross-linking of collagen reduces the thickness of the scar and also makes the skin area of the wound stronger. It normally starts about 20 days after an injury. The healed wound areas continue to be weaker and have less tensile strength than unwounded skin.


Scar management is an option after this stage with gels, ointments, and gel sheets. Wound management can be a tedious task but with the right products and the right treatment methods, one can easily get through with ease and comfort.


Disclaimer: All content found on our website, including images, videos, infographics and text were created solely for informational purposes. Our content should never be used for the purpose of diagnosis or treatment of any medical conditions. Content shared on our websites is not meant to be used as a substitute for advice from a certified medical professional. Reliance on the information provided on our website as a basis for patient treatment is solely at your own risk. We urge all our customers to always consult a physician or a certified medical professional before trying or using a new medical product.