During the repair phase (granulation tissue and epithelialization) of wound healing, which factor can impair it?

• A. Hypoxia
• B. Necrotic tissue
• C. Infection
• D. Edema

Answer: (B)

During the repair phase, healing depends on a clean wound bed where granulation tissue can form and epithelial cells can migrate to re-epithelialize. Necrotic tissue is nonviable and acts as a barrier to this process. It blocks cell migration, impedes diffusion of oxygen and nutrients, and sustains inflammation while potentially harboring bacteria. This hostile environment prevents fibroblasts and keratinocytes from populating the wound and laying down new tissue. Removing dead tissue through debridement is essential to allow granulation tissue to form and for epithelial cells to move across the bed to restore surface integrity. While other factors like infection or edema can worsen healing, necrotic tissue directly hinders the repair process by creating an unreceptive wound bed.