A text-book of first aid and emergency treatment . ound of the hand. (Ashhurst.) In time proliferation of the cellular elements holds thewound edges firmly together, and healing is complete. Thereis little or no discharge from such a wound. ^Yhen there is suppuration or M^hen the edges of the woimdare not approximated, the \\ound heals by granulation. Insuch cases the wound fills from the bottom and the edges,which become covered with a soft bright red cellular tissuecalled granulation tissue. The slow proliferation of thistissue gradually fills the wound until it reaches the level ofthe skin.
A text-book of first aid and emergency treatment . ound of the hand. (Ashhurst.) In time proliferation of the cellular elements holds thewound edges firmly together, and healing is complete. Thereis little or no discharge from such a wound. ^Yhen there is suppuration or M^hen the edges of the woimdare not approximated, the \\ound heals by granulation. Insuch cases the wound fills from the bottom and the edges,which become covered with a soft bright red cellular tissuecalled granulation tissue. The slow proliferation of thistissue gradually fills the wound until it reaches the level ofthe skin. The skin slowly grows inward from the margin THE REPAIR OF WOUNDS 81 of the denuded area, finally covering the surface of thewound. Primary union, or healing by first intention, usually takesplace in about a week and the union is firm at the end of thesecond week. Compared with this, healing by granulationis very slow. Even a comparatively small wound may requireseveral weeks, and large wounds may not be entirely healedafter four or five Fig. 37.—Infection of the finger from a neglected wound. This shouldhave been incised several days before. (Park.) Clinical Course of Infected Wounds.—When a wound isinfected there is a period varying from a, few hom:s to afew days during which it is to all appearances aseptic. Thisis the incubation period during which the bacteria, thoughpresent and active, do not make themselves evident. Following this is the stage of reaction when the woundbecomes painful and tender. The edges are reddened andindurated (hard). The presence of bacteria causes a con-gestion in the region of the wound. The white cells arethrown out as a protective agency to destroy the bacteria,6 82 WOUNDS AND WOUND INFECTION and in cortain sta,u:es of tlio i)r()(rss tlio Avliitc (vlls may hesorn, niion)sc()])ically, in the ])rcHess of clo\ourin,u tlio bac-teria. The mixture of sermn, bacteria, Avhite blood cells, andpartially destroyed tissue cells is called pus.
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