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Surgery > Fiser ABSITE Ch. 14 Wound Healing > Flashcards

Fiser ABSITE Ch. 14 Wound Healing Flashcards

1
Q

What are the 3 wound healing phases?

A

Inflammation, Proliferation, Remodeling

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2
Q

What is the timeframe for the inflammation phase of wound healing?

A

days 1-10

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3
Q

What is the timeframe for the proliferation phase of wound healing?

A

5 days - 3 weeks

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4
Q

What is the timeframe for the remodeling phase of wound healing?

A

3 weeks - 1 year

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5
Q

Which phase of wound healing?:

PMNs, macrophages, epithelialization 1-2 mmday

A

Inflammation

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6
Q

Which phase of wound healing?:

fibroblasts, neovascularization, production of collagen, granulation tissue

A

Proliferation

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7
Q

Which phase of wound healing?:
Type III collagen replaced with type I; decreased vascularity. Net amount of collagen does not change, although significant production and degradation occur. Collagen cross-linking occurs.

A

Remodeling

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8
Q

Peripheral nerves regenerate at ___ mmday

A

1

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9
Q

Fibroblasts replace fibronectin-fibrin with ___

A

collagen

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10
Q

Chemotactic for macrophages also anchors fibroblasts.

A

Fibronectin

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11
Q

Name the predominant cell type by wound healing day:
Days 0-2 ___
Days 3-4 ___
Days 5 and on ___

A

PMNs
macrophages
fibroblasts

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12
Q

Platelet plug is made of platelets and ___

A

fibrin

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13
Q

Provisional matrix is made of platelets, ___ and ___

A

fibrin, fibronectin

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14
Q

Accelerated wound healing is quicker healing that occurs when reopening a wound the 2nd time. Why does this occur?

A

healing cells are already present

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15
Q

Which type of platelet granules contain: Platelet factor for aggregation. Beta-thrombomomdulin to bind thrombin and PDGF a chemoattractant.

A

Alpha granules

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16
Q

Which type of platelet granule contains adenosine, serotonin and calcium.

A

Dense granules

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17
Q

Name 3 platelet aggregation factors.

A

TXA2, thrombin, platelet factor 4

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18
Q

The most important factor in healing open wounds (secondary intention).

A

epithelial integrity

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19
Q

Epithelial migration occurs from what three places in wound healing?

A

wound edges, sweat glands, and hair follicles

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20
Q

Unepithelialized wounds leak ___ and protein, promote bacterial

A

serum

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21
Q

What is the most important factor in healing closed incisions (primary intention).

A

tensile strength

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22
Q

Tensile strengh depends on what?

A

collagen deposition and cross-linking

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23
Q

What is the strength layer of the bowel?

A

submucosa

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24
Q

What is the weakest time point for small bowel anastomosis?

A

3-5 days

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25
Q

Myofibroblasts communicate by ___

A

gap junctions

26
Q

What part of wound healing are myofibroblasts involved in?

A

wound contraction and healing by secondary intention

27
Q

What is the most common type of collagen

A

Type I

28
Q

Name the type of collagen:

skin, bone and tendons

A

I

29
Q

Name the type of collagen: Cartilage

A

II

30
Q

Name the type of collagen: increased in wound healing, also in blood vessels and skin

A

III

31
Q

Name the type of collagen: basement membranes

A

IV

32
Q

Name the type of collagen: widespread, particularly found in the cornea

A

V

33
Q

Alpha-ketoglutarate, vitamin C, oxygen and iron are required for what part of wound healing?

A

hydroxylation of proline and subsequent cross-linking of proline residues

34
Q

Collagen has ___ every 3rd amino acid; also has abundant lysine

A

proline

35
Q

Wound tensile strength is never equal to prewound, only ___%

A

80%

36
Q

What is the predominant collagen type synthesized for days 1-2?

A

Type III

37
Q

What is the predominant collagen type synthesized by days 3-4?

A

Type I

38
Q

Type III collagen is replaced by type I by ___ weeks

A

3

39
Q

At ___ weeks wound is at 80% of its final strength and 60% of its original strength.

A

6

40
Q

At ___ weeks, wound reaches maximum tensile strength, which is 80% of its original strength

A

8

41
Q

Maximum collage accumulation at ___ weeks after that -> the amount of collagen stays the same but continued cross-linking improves strength

A

2-3

42
Q

d-Penicillamine is used to treat RA, what does it do to wound healing

A

inhibits collagen cross linking

43
Q

What is the transcutaneous oxygen measurement essential for wound healing?

A

> 25 mmHg

44
Q

bacteria amount > ___ is an impediment to wound healing

A

10^5cm2

45
Q

Albumin less than ___ is a risk factor for poor wound healing

A

3

46
Q

Steroids prevent wound healing by inhibiting macrophages, PMNs and collagen synthesis by ___; decreased wound tensile strength as well.

A

fibroblasts

47
Q

What vitamin (24,000 IU qd) counteracts effects of steroids on wound healing?

A

Vitamin A

48
Q

Name the disease associated with abnormal wound healing: Type I collagen defect.

A

osteogenesis imperfecta

49
Q

Name the disease associated with abnormal wound healing: 10 types identified, all collagen disorders

A

Ehlers-Danlos syndrome

50
Q

Name the disease associated with abnormal wound healing: fibrillin (collagen) defect

A

Marfan’s syndrome

51
Q

Name the disease associated with abnormal wound healing: Excessive firbroblasts. Tx: phenytoin

A

Epidermolysis bullosa

52
Q

90% of leg ulcers due to ___. Tx?

A

venous insufficiency. Unna boot, elastic wrap

53
Q

Scar revisions, wait for ___ to allow maturation; may improve with age

A

1 year

54
Q

What pts heal with little or no scarring?

A

infants

55
Q

What type of tissue contains no blood vessels

A

cartilage

56
Q

Does denervation have an effect on wound healing?

A

no

57
Q

Chemotherapy has no effect on wound healing after ___ days

A

14

58
Q

What is the inheritance for keloids?

A

autosomal dominant

59
Q

Tx for keloids?

A

XRT, steroids, silicone, pressure garments

60
Q

What is the difference between a Keloid and hypertrophic scar tissue.

A

Keloids extend beyond original scar

61
Q

Hypertrophic scar tissue often occurs in what type of wounds and what is the tx?

A

flexor surfaces of upper torso, burns or wounds that take a long time to heal; Steroids, silicone, pressure garments.

Surgery (33 decks)

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