Basic wound healing Flashcards
Describe first intention healing
Primary closure
Examples: Suture incisions, heals by tissue apposition
Describe second intention healing (3 steps)
Granulation
Contraction
Epithelialization
5 phases of wound healing (IMPORTANT)
Wounding Vascular phase Inflammatory phase cellular phase maturation phase
5 phases of wound healing (IMPORTANT)
Wounding Vascular phase Inflammatory phase cellular phase maturation phase
What happens in the vascular phase? (4)
Hemorrhage, hemostasis
Endothelial injury
cellular adhesion
coagulation
What happens in the cellular phase?
Fibroplasia (proliferation)
What happens in maturation phase?
decrease amount and increase quality via cross linking etc
What happens in the inflammatory phase?
Inflammatory reaction, localized response elcicted by injury.
Destroys, dilutes or walls off injured tissue to prepare for the repair
Important to remember there is an increase in permeability
What substance in important for early permebaility increase in the inflammatory phase?
What comes later on?
Histamine
Serotonin (more significant)
What do prostaglandins do? Why is this very pertinant to surgery?
Permeability changes, vasoactive, chemotaxis
NSAIDS block them, not really that important thtough, pain control is more important
Common chemotactic agents in inflammatory phase?
cytokines
Common chemotactic agents in inflammatory phase?
cytokines
What are granulocytes sensitive to? What are 2 of their purposes?
PH
Antibacterial
Proteolytic enzymes
What are granulocytes sensitive to? What are 2 of their purposes?
PH
Antibacterial
Proteolytic enzymes
Classic signs of inflammation? (4)
redness
heat
swelling
pain
3 cytokines that macrophages release?
TGF 2 alpha
TGG beta
IFG-1
3 parts of epithelization
Fibrin-fibronectin seal
epithelial migration
epithelial proliferation
4 parts of cellular phase
fibroblast infiltration
Ground substance secretion
capillary ingrowth
granulation tissue formation
3 major components of granulation tissue
Capillary loop
fibroblast
macrophage
Main function of fibroblast infiltration in the cellular phase
Fibrin-Fibronectin scaffold and fibrinolysis
3 major process of the maturation phase
crosslinking - aldehyde bonds
Collagen remodelling - collagen remodeling
Decrease cellularity
3 surgeon factors contributing to wound healing efficiency
Tissue handling
Procedure duration
Suture material
3 major components of the wound microenvironment
oxygen tension
temperature
pH
3 major components of the wound microenvironment
oxygen tension
temperature
pH
What kind of oxygen tension favors granulation tissue formation?
Low oxygen tension
