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7th > Chapter 149 - Wound Healing > Flashcards

Chapter 149 - Wound Healing Flashcards

1
Q

MMPs essential for remodeling

A

1, 9, 10

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2
Q

This type of cell plays a major role in secondary intention healing

A

Myofibroblasts

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3
Q

Factors that influence healing

A
  1. Depth of wound
  2. Location of wound
  3. Vascular supply
  4. Presence of infection
  5. Wound shape
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4
Q

Phases of wound healing

A
  1. Coagulation
  2. Inflammatory Phase
  3. Proliferative and Migratory Phase
  4. Remodeling Phase
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5
Q

The most important regulatory cells in inflammatory process of wound healing

A

Macrophages

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6
Q

Cells that appear in wound site 72 hours after injury

A

Macrophages

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7
Q

Main cell type during coagulation phase of wound healing

A

Platelets

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8
Q

Main cell type in remodeling phase

A

Myofibroblasts

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9
Q

Proliferative phase is characterized by:

A
  1. Fibroblast migration
  2. Deposition of ECM
  3. Formation of granulation tissue
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10
Q

Important event in proliferation phase

A

Reepithelialization

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11
Q

Most abundant protein in the body made by fibroblasts

A

Collagen

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12
Q

Polypeptide growth factors essential to angiogenesis

A

bFGF and VEGF

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13
Q

Essential components of the basement membrane and anchoring fibrils

A

Collagen IV and Collagen VII

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14
Q

Plays a fundamental role in cutting Type IV and Type VII collagen

A

MMP9

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15
Q

Essential for resurfacing of wound

A

Migration of keratinocytes

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16
Q

Longest phase of wound healing

A

Remodeling

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17
Q

Scar matured and tensile strength increases to maximum of ______ of noninjured skin

A

80%

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18
Q

In full thickness wounds, contraction is responsible for ____ decrease in wound size

A

40%

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19
Q

Small glycoprotein that mediates scarless healing in fetal skin

A

Fibromodulin

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20
Q

US FDA- approved for wound healing

A

PDGF

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21
Q

TGF B predominates in wound healing

A

1

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22
Q

TGF which promotes fibrosis and scar formation

A

1 and 2

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23
Q

TGF antifibrotic properties

A

3

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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

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25
Q

Plays a role in granulation tissue formation, reepithelialization, tissue remodeling

A

FGF2 or bFGF

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26
Q

Important role in blood vessel maturation and works synergistically with hypoxia to stimulate VEGF formation

A

PDGF

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27
Q

FDA- approved drug for nonhealing neuropathic diabetic foot ulcers

A

PDGF BB (becaplermin)

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28
Q

Major stimulus for release of VEGF- A

A

Hypoxia

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29
Q

Cytokine that negatively impacts wound healing

A

IFN- inducible protein 10 (CXCL10)

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30
Q

Inhibits migration of fibroblasts

A

IFN-inducible protein 10

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31
Q

Increases keratinocyte migration and proliferation

A

IL8

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32
Q

Wound bed preparation has been summarized as T.I.M.E

A

Tissue debridement
Infection/Inflammation
Moisture balance
Epithelial edge tissue

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33
Q

True or False.

Topical antibiotics are NOT recommended for chronic wounds due to the risk of antibiotic resistance.

34
Q

FDA approved for partial and full thickness venous leg ulcers greater than 4 weeks duration

A

BLCC (Bilayered living cellular construct)

35
Q

FDA approved for full thickness diabetic ulcers present for longer than 3 weeks

A

BLCC (bilayered living cellular construct)

36
Q

FDA approval for diabetic foot ulcers longer than 6 weeks that do not involve the tendon, muscle, joint capsule/bones

A

Cellular dermal matrix

37
Q

Only known medical approach for decreasing recurrence of venous ulcers

A

40mmHg graded elastic stockings

38
Q

Chronic wounds are often the result of (3)

A

Ischemia
Pressure
Infection

39
Q

Type of healing characterized by healing by first or primary intention, which is closure of the wound after creation

A

Primary healing

40
Q

Healing through a process that includes granulation tissue formation and epithelialization

A

Healing by secondary intention

41
Q

Myofibroblasts appear ___ days after injury and reaching a max ___ days postinjury

A

3 days

10-21 days

42
Q

Occurs when a wound originally closed by primary intention dehisces and then heals by secondary intention

A

Tertiary intention

43
Q

__ facilitates cell migration by increased microvascular permeability

44
Q

Specific enzyme to initiate intrinsic coagulation cascade

A

Hageman factor XII

45
Q

____ infiltrates to wound site within 24 to 48 hours of injury

A

Neutrophil

46
Q

Key regulator cells for repair as main phagocytic cells that release collagenases

A

Macrophages

47
Q

M1 phenotype represents

M2 phenotype represents

A

1- classically activated

2- alternatively activated

48
Q

Acute inflammatory response lasts

49
Q

Fibrillar collagens (3) form the connective tissue in the healing wound

50
Q

__ stimulates production of collagen I and III

51
Q

Critical to the movement of cells through provisional structural matrix components

A

Plasminogen activator inhibitor

52
Q

Characteristic of proliferation phase

A

Neovascularization

53
Q

Fibroblast replication and longevity are enhanced in __

54
Q

Important for keratinocyte migration

A

Upregulation of tissue plasminogen activator and urokinase plasminogen activator

55
Q

Important reservoir for keratinocytes in partial thickness wounds

A

Hair bulge

56
Q

Degrades collagen I, II, III

A

Interstitial collagenases

57
Q

Degrades denatured collagen and fibronectin

A

Gelatinases

58
Q

Degrades proteoglycan, laminin, fibronectin, and amorphous collagen

A

Stromelysins

59
Q

Breaks down other noncollagenous ECM components and facilitates migration

A

MMP10 (stromelysin)

60
Q

Plays an important role in reepithelialization by increasing keratinocyte proliferation and cell migration

A

Epidermal Growth Factor

61
Q

Plays a major role in collagen production and inhibits collagen breakdown by inhibiting MMPs and promoting TIMP1

62
Q

Overexpression is associated with delayed healing

A

Bone morphogenetic protein 6

63
Q

Decreased in chronic wounds

A

bFGF or FGF2

64
Q

Strong mitogen of vascular endothelial cells and is important during neovascularization

65
Q

Bacteria delay wound healing through formation of biofilm, seen in __% of chronic wounds

66
Q

Difference between antiseptic and antibiotic

A

Antiseptics are broad spectrum/nonspecific with less risk of bacterial resistance.
Antibiotics can lead to development of resistance

67
Q

Type of debridement is contraindicated in ischemic tissue and bleeding disorders

A

Surgical debridement

68
Q

Type of debridement contraindicated in those with allergies

A

Enzymatic (collagenase)

69
Q

Type of debridement contraindicated in bleeding diathesis and deep tunneling wounds

A

Biologic (larval therapy)

70
Q

Type of debridement contraindicated in infected wounds

71
Q

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

72
Q

Polymers with high water content are contraindicated in infected wounds

73
Q

Non absorptive, impermeable to water and bacteria

74
Q

Composed of gelatin, pectin, and carboxymethylcellulose with allergy to adhesives

A

Hydrocolloids

75
Q

Examples of absorptive dressings

A

Calcium alginate

Gelling fibers

76
Q

Split thickness skin grafts can survive in areas with __ vascularity and ___ likely to prevent wound contracture

A

Less, less

77
Q

Human placental products composed of single later of epithelial cells, basement membrane, and connective tissue matrix

A

Dehydrated human amnion/chorion membrane (Epifix)

78
Q

Composed of placental membrane, source of mesenchymal stem cells, neonatal fibroblasts, epithelial cells, growth factors, and angiogenic cells

A

Cryopreserved placental membrane (Grafix)

79
Q

Acellular matrix approved for burns and diabetic foot ulcers

A

Dermal regeneration matrix (Integra Dermal Regeneration Template)

80
Q

Indicated for tissue repair in abdominal wall and breast reconstruction

A

Cadaveric allograft

81
Q

Lack of response venous ulcers to action of TGF B1 and PDGF due to decrease in

A

Type II TGFB receptors

82
Q

Effective in diminishing induration of lipodermatosclerosis

A

Stanazolol

7th (23 decks)

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