Factors Affecting Wound Healing Flashcards
What can be defined as an acute wound?
a wound that is induced by surgery or trauma in an otherwise healthy individual
What can be defined as a chronic wound?
A wound whose progression through the phases of wound healing is prolonged or arrested due to underlying conditions
What are 4 deterrents to expedient wound healing?
1) Wound characteristics
2) Local factors
3) Systemic factors
4) Inappropriate wound management
What are the 9 wound characteristics that affect the rate of wound healing?
- Mechanism of onset
- Time since onset
- Wound location
- Wound dimensions
- Temperature
- Wound hydration
- Necrotic tissue or foreign bodies
- Infection
Do surgical or traumatic wounds heal faster?
surgical, because there is less cell and tissue damage
What are insidious wounds usually due to?
An underlying pathology such as arterial or venous insufficiency
True or False
Time since onset can assist with predicting healing time in both acute and chronic wounds
False, only in acute wounds
In what locations do wounds heal more slowly?
- areas of low vascularity
- over bony prominences
- in areas with fewer epidermal appendages
- where the skin is thicker
Why do circular wounds tend to take longer to heal?
Because there is more surface area to cover
Maintaining a normothermic wound environment has been shown to improve wound healing. This ranges from __ to __ degrees Celsius
37-38
How long does it take a wound to dehydrate if left to air dry?
2-3 hours
How does desiccation slow the wound healing process?
It slows epithelial cell migration by increasing the distance epithelial cells must travel and requires greater enzyme production to break down the crust, ultimately delaying healing
If a wound becomes too wet what will occur?
maceration to the periwound tissue
A moist wound is ideal for wound healing, explain why.
Because it traps growth factors and enzymes, optimizing wound healing
Necrotic tissue _____ infection, whereas foreign bodies ______ inflammation
promotes
prolong
What is the definition of infection?
The invasion and multiplication of microorganisms in body tissues
A wound culture is considered infected if a wound culture contains greater than 10^___ microbes per g/tissue
5
Essentially when should infection be suspected?
When the signs and symptoms similar to inflammation are present but disproportionate to the wound
What is the definition of colonization?
the mere presence of microbes, which does not immediately signify wound infection
Normal wound culture can contain up to 10^_ microbes per g/tissue
3
What are the 5 key differences between a chronic wound and an acute wound?
- contains senescent cells
- have a dramatic increase in the number of inflammatory mediators
- reduced or arrested epithelialization (non-advancing wound edge)
- greater bioburden (increased level of microbes)
What are 3 local factors known to affect wound healing?
- circulation
- sensation
- mechanical stress
True or False
It is possible to have adequate macrocirculation and inadequate microcirculation to the wound bed
True
What 3 sympathetic responses lead to vasoconstriction and thereby reduce wound healing?
pain, cold, and fear
How do we as clinicians teach our patients to be judicious with skin health of the patient’s sensation is impaired?
Encourage daily skin checks of the insenate areas
Mechanical stress can come in 5 forms, what are they?
- pressure
- shear
- friction
- periwound edema
- tension on wound edges
How can periwound edema impede would healing?
By restricting blood flow
What are 5 systemic factors that affect wound healing?
- Age
- Inadequate nutrition
- Comorbidities
- Medication
- Behavioral risk taking
What are the 8 anatomical and functional changes that slow wound healing related to age?
- Slowed immune response
- Decreased collagen synthesis and strength
- Epidermal/dermal atrophy
- Decreased number of sweat and oil glands
- Decreased pain perception
- Decreased inflammatory response
- Greater number of comorbidities
- Increased susceptibility of infection
Describe why adequate nutrition is vital to wound healing.
Active cells require energy to function, with carbs being the preferred fuel source. If not present, the body will turn to amino acids from protein. Because protein is required for cellular repair and regeneration, protein depletion will impair inflammation, immune response, proliferation, and maturation.
What are 3 examples of disease processes that affect tissue perfusion therefore wound healing?
- anemia
- PVD
- COPD
Steroids at doses greater than __-__ mg/day impair all phases of wound healing. Explain why the 3 reasons why…
30-40
They suppress inflammation and the immune system, decrease angiogenesis and epithelialization, and slow proliferation.
True or False
Chemotherapy slows wound healing
True
What are the 3 effects alcohol abuse has on wound healing?
- malnutrition
- increased risk of injury
- less likely to see medical care
What are the 3 effects smoking has on wound healing?
- peripheral vasoconstriction
- increased platelet aggregation and clot strength, amking the body work harder to dissolve clots
- carbon monoxide binds to hemoglobin reducing oxygen availability
Smokers are - times more likely to develop infection than nonsmokers
3-5
What are 5 patient-related issue to inappropriate wound management?
- Home remedies
- Not following recommended treatment
- Lack of understanding of information provided
- Limited financial resources
- Insufficient caregiver support
What are 5 clinician-related issue to inappropriate wound management?
- Failure to follow established guidelines
- Failure to properly educate patient
- Exposure to air or inappropriate dressing
- Inappropriate use of antiseptics
- Overuse of whirlpool
