Chapter 149 - Wound Healing Flashcards
1
Q
MMPs essential for remodeling
A
1, 9, 10
2
Q
This type of cell plays a major role in secondary intention healing
A
Myofibroblasts
3
Q
Factors that influence healing
A
- Depth of wound
- Location of wound
- Vascular supply
- Presence of infection
- Wound shape
4
Q
Phases of wound healing
A
- Coagulation
- Inflammatory Phase
- Proliferative and Migratory Phase
- Remodeling Phase
5
Q
The most important regulatory cells in inflammatory process of wound healing
A
Macrophages
6
Q
Cells that appear in wound site 72 hours after injury
A
Macrophages
7
Q
Main cell type during coagulation phase of wound healing
A
Platelets
8
Q
Main cell type in remodeling phase
A
Myofibroblasts
9
Q
Proliferative phase is characterized by:
A
- Fibroblast migration
- Deposition of ECM
- Formation of granulation tissue
10
Q
Important event in proliferation phase
A
Reepithelialization
11
Q
Most abundant protein in the body made by fibroblasts
A
Collagen
12
Q
Polypeptide growth factors essential to angiogenesis
A
bFGF and VEGF
13
Q
Essential components of the basement membrane and anchoring fibrils
A
Collagen IV and Collagen VII
14
Q
Plays a fundamental role in cutting Type IV and Type VII collagen
A
MMP9
15
Q
Essential for resurfacing of wound
A
Migration of keratinocytes
16
Q
Longest phase of wound healing
A
Remodeling
17
Q
Scar matured and tensile strength increases to maximum of ______ of noninjured skin
A
80%
18
Q
In full thickness wounds, contraction is responsible for ____ decrease in wound size
A
40%
19
Q
Small glycoprotein that mediates scarless healing in fetal skin
A
Fibromodulin
20
Q
US FDA- approved for wound healing
A
PDGF
21
Q
TGF B predominates in wound healing
A
1
22
Q
TGF which promotes fibrosis and scar formation
A
1 and 2
23
Q
TGF antifibrotic properties
A
3
24
Q
3 main members of FGF family involved in wound healing
A
2 /bFGF
7/ keratinocyte growth factor 1
10/ keratinocyte growth factor 2
25
Plays a role in granulation tissue formation, reepithelialization, tissue remodeling
FGF2 or bFGF
26
Important role in blood vessel maturation and works synergistically with hypoxia to stimulate VEGF formation
PDGF
27
FDA- approved drug for nonhealing neuropathic diabetic foot ulcers
PDGF BB (becaplermin)
28
Major stimulus for release of VEGF- A
Hypoxia
29
Cytokine that negatively impacts wound healing
IFN- inducible protein 10 (CXCL10)
30
Inhibits migration of fibroblasts
IFN-inducible protein 10
31
Increases keratinocyte migration and proliferation
IL8
32
Wound bed preparation has been summarized as T.I.M.E
Tissue debridement
Infection/Inflammation
Moisture balance
Epithelial edge tissue
33
True or False.
| Topical antibiotics are NOT recommended for chronic wounds due to the risk of antibiotic resistance.
True
34
FDA approved for partial and full thickness venous leg ulcers greater than 4 weeks duration
BLCC (Bilayered living cellular construct)
35
FDA approved for full thickness diabetic ulcers present for longer than 3 weeks
BLCC (bilayered living cellular construct)
36
FDA approval for diabetic foot ulcers longer than 6 weeks that do not involve the tendon, muscle, joint capsule/bones
Cellular dermal matrix
37
Only known medical approach for decreasing recurrence of venous ulcers
40mmHg graded elastic stockings
38
Chronic wounds are often the result of (3)
Ischemia
Pressure
Infection
39
Type of healing characterized by healing by first or primary intention, which is closure of the wound after creation
Primary healing
40
Healing through a process that includes granulation tissue formation and epithelialization
Healing by secondary intention
41
Myofibroblasts appear ___ days after injury and reaching a max ___ days postinjury
3 days
| 10-21 days
42
Occurs when a wound originally closed by primary intention dehisces and then heals by secondary intention
Tertiary intention
43
__ facilitates cell migration by increased microvascular permeability
Serotonin
44
Specific enzyme to initiate intrinsic coagulation cascade
Hageman factor XII
45
____ infiltrates to wound site within 24 to 48 hours of injury
Neutrophil
46
Key regulator cells for repair as main phagocytic cells that release collagenases
Macrophages
47
M1 phenotype represents
| M2 phenotype represents
1- classically activated
| 2- alternatively activated
48
Acute inflammatory response lasts
2 weeks
49
Fibrillar collagens (3) form the connective tissue in the healing wound
1,3,5
50
__ stimulates production of collagen I and III
TGFB
51
Critical to the movement of cells through provisional structural matrix components
Plasminogen activator inhibitor
52
Characteristic of proliferation phase
Neovascularization
53
Fibroblast replication and longevity are enhanced in __
Hypoxia
54
Important for keratinocyte migration
Upregulation of tissue plasminogen activator and urokinase plasminogen activator
55
Important reservoir for keratinocytes in partial thickness wounds
Hair bulge
56
Degrades collagen I, II, III
Interstitial collagenases
57
Degrades denatured collagen and fibronectin
Gelatinases
58
Degrades proteoglycan, laminin, fibronectin, and amorphous collagen
Stromelysins
59
Breaks down other noncollagenous ECM components and facilitates migration
MMP10 (stromelysin)
60
Plays an important role in reepithelialization by increasing keratinocyte proliferation and cell migration
Epidermal Growth Factor
61
Plays a major role in collagen production and inhibits collagen breakdown by inhibiting MMPs and promoting TIMP1
TGF B1
62
Overexpression is associated with delayed healing
Bone morphogenetic protein 6
63
Decreased in chronic wounds
bFGF or FGF2
64
Strong mitogen of vascular endothelial cells and is important during neovascularization
FGF7
65
Bacteria delay wound healing through formation of biofilm, seen in __% of chronic wounds
60%
66
Difference between antiseptic and antibiotic
Antiseptics are broad spectrum/nonspecific with less risk of bacterial resistance.
Antibiotics can lead to development of resistance
67
Type of debridement is contraindicated in ischemic tissue and bleeding disorders
Surgical debridement
68
Type of debridement contraindicated in those with allergies
Enzymatic (collagenase)
69
Type of debridement contraindicated in bleeding diathesis and deep tunneling wounds
Biologic (larval therapy)
70
Type of debridement contraindicated in infected wounds
Autolytic
71
Matching type
1. May damage cartilage/ear toxicity
2. May produce pseudoeschar/ delay healing
3. Risk of botulism
4. Toxic to granuloma at high concentration
A. Povidone iodine
B. Silver sulfadiazine
C. Chlorhexidine
D. Honey
C
B
D
A
72
Polymers with high water content are contraindicated in infected wounds
Hydrogels
73
Non absorptive, impermeable to water and bacteria
Films
74
Composed of gelatin, pectin, and carboxymethylcellulose with allergy to adhesives
Hydrocolloids
75
Examples of absorptive dressings
Calcium alginate
| Gelling fibers
76
Split thickness skin grafts can survive in areas with __ vascularity and ___ likely to prevent wound contracture
Less, less
77
Human placental products composed of single later of epithelial cells, basement membrane, and connective tissue matrix
Dehydrated human amnion/chorion membrane (Epifix)
78
Composed of placental membrane, source of mesenchymal stem cells, neonatal fibroblasts, epithelial cells, growth factors, and angiogenic cells
Cryopreserved placental membrane (Grafix)
79
Acellular matrix approved for burns and diabetic foot ulcers
Dermal regeneration matrix (Integra Dermal Regeneration Template)
80
Indicated for tissue repair in abdominal wall and breast reconstruction
Cadaveric allograft
81
Lack of response venous ulcers to action of TGF B1 and PDGF due to decrease in
Type II TGFB receptors
82
Effective in diminishing induration of lipodermatosclerosis
Stanazolol
