CH 14 Normal Wound Healing Flashcards
A process that is continuous while its phases are not entirely distinct
Wound healing
The number of days to complete each phase will vary by what factors?
Age, size of wound, comorbidities, continued trauma, nutrition, blood flow, medications, stress, infection
What phase is a NORMAL immune system reaction to injury?
Inflammation (Phase I)
What phase is the CENTRAL ACTIVITY in wound healing?
Inflammation (Phase I)
What phase is where temporary repair is initiated by coagulation (clotting factors, platelets) and SHORT-TERM DECREASED blood flow occurs?
Inflammation (Phase I)
What phase is where NECROSIS occurs after cells have been injured or destroyed?
Inflammation (Phase I)
What phase is where the spread of pathogens is slowed; debris and bacteria are attacked by a host of cells?
Inflammation (Phase I)
Fluid that accumulates at the injury site during the inflammation phase (phase I)?
Pus
If the wound is acute, what can be expected in the inflammation phase (phase I)?
Edema, erythema, and drainage
What phase has oxygen being delivered via INCREASED blood flow to keep the phagocytic cells alive and functioning?
Inflammation (Phase I)
What phase is where permanent repair is facilitated by creating a clean wound, SETTING THE STAGE for the next phase of healing; re-epithelialization can begin?
Inflammation (Phase I)
What phase has a time frame from day of injury to approx day 10?
Inflammation (Phase I)
What phase is when the RATE of inflammatory process if affected by the size of wound, blood supply, available nutrients, and extrinsic environment?
Inflammation (Phase I)
What happens when the inflammation phase is interrupted or delayed?
Chronic inflammation
What phase is where NEW TISSUE fills the wound as fibroblasts secrete collagen?
Proliferation (Phase II)
What phase is where skin integrity is restored by re-epithelialization and/or contraction?
Proliferation (Phase II)
What phase is where angiogenesis occurs; new blood vessel growth from endothelial cells and fragile capillary buds grow into the wound bed; new reddish, slightly bumpy tissue is called GRANULATION TISSUE?
Proliferation (Phase II)
What phase is where epithelial cells differentiate into Type I Collagen?
Proliferation (Phase II)
What phase is where COLLAGEN SYNTHESIS occurs but the resulting new scar tissue is fragile and must be protected; trauma during this phase may return the wound to the inflammatory phase?
Proliferation (Phase II)
What phase has a time frame from day 3 of injury to approx day 20?
Proliferation (Phase II)
What phase is when the RATE of proliferation is affected by the size of the wound, blood supply, available nutrients, and the extrinsic environment?
Proliferation (Phase II)
What phase may result in a chronic wound if interrupted or delayed?
Proliferation (Phase II)
What phase occurs when maturation or remodeling of new tissue begins while granulation tissue is forming during the prior phase?
Maturation/Remodeling (Phase III)
What phase is when epithelial cells continue to differentiate into type I collagen?
Maturation/Remodeling (Phase III)
What phase is when new skin has tensile strength that is 15% of normal; scar tissue is rebuilding but at best reaches 80% of original tensile strength?
Maturation/Remodeling (Phase III)
What phase is when underlying granulation tissue is replaced by less vascular tissue?
Maturation/Remodeling (Phase III)
What phase is when deep wounds have dermal appendages that are rarely repaired (hair follicles, sebaceous and sweat gland, nerves) but instead are replaced by fibrous tissue?
Maturation/Remodeling (Phase III)
What phase is when over time the scar tissue matures, changing from red to pink to white and from raised to rigid to flat and flexible?
Maturation/Remodeling (Phase III)
What phase has a time frame of approximately day 9 of injury up to 2 years?
Maturation/Remodeling (Phase III)
What is necessary to sustain life at the cellular and systemic level?
Oxygen in wound healing
What occurs when oxygenated blood flows to the tissues of the body?
Perfusion
What reaches the wound beds through blood flow to the area?
Oxygen (role in wound healing)
Wound contraction, collagen deposition, angiogenesis, and granulation are all examples of wound healing supported by what?
Oxygen perfusion
What is a sensitive indicator for the risk of post-operative infection?
Wound tissue oxygenation or perfusion (role in wound healing)
What would a decrease in oxygen availability lead to in wound healing?
Increases likelihood of infection
What are the two most common problems that limit perfusion?
Edema and necrosis