The proliferative phase involves the production of highly vascular granulation tissue (a form of connective tissue) which fills the wound and provides a scaffold for further healing. The proliferative process is triggered by an environment of low wound pH, reduced PaO2 and increased lactate (due to reduced blood supply to the wound).

Granulation Wound Care (Second Intent Wound Healing) Your wound will be left to heal in naturally or by second intention healing. This means that there are no sutures in your wound. Your wound will fill up naturally with new tissue from the bottom up and then close itself in from the sides.

In healthy stages of wound healing, granulation tissue is pink or red and uneven in texture. Moreover, healthy granulation tissue does not bleed easily. Dark granulation tissue can be a sign of infection, ischemia, or poor perfusion. In the final phase of the proliferative stage of wound healing, epithelial cells resurface the injury.

Certain wound care interventions, such as cauterization and the use of appropriate medications and dressings, can encourage the proliferation of granulation tissue to promote healing.