Inflammation and Healing

Question 1

Cardinal signs of inflammation

Answer 1

Heat, Redness, Swelling, and Pain (+ loss of function)

Question 2

Classification of inflammation

Answer 2

• Acute: from hours to several days.
• Subacute: after resolution of the immediate acute inflammation. From hours to several weeks.
• Chronic: can be a sequel to the other phases, occur as a result of prolonged healing or be chronic from the onset.

Question 3

Wound healing categories

Answer 3

• First intention healing: clinical or surgical wound or of a skin-penetrating injury with clear, clean margins that have not become separated or that can be closed using sutures, staples or Steristrips.
• Second intention healing: delayed healing of a surgical wound or healing of a nonsurgical wound.

Question 4

Fibrous connective tissue repair process

Answer 4

1. Contraction of the wound (proliferative phase)
2. Formation of granulation tissue (proliferation phase)
3. Organization
4. Scar Tissue
5. Remodelling of the scar tissue (maturation phase)

Question 5

Factors causing delayed wound healing

Answer 5

• Location of the wound
• Excessive movement
• Foreign bodies
• Size of the wound
• Infections
• Age
• Circulatory conditions
• Nutritional status
• Interference by the patient
• Medications (corticosteroids and anticoagulants interfere with the healing process)

Question 6

Stimulation for wound healing

Answer 6

• Electrical stimulation: galvanic and pulsed monophasic currents using neg as active. Biphasic current too.
• US
• Pulsatile lavage: water under pressure to clean and debride
• Short-wave diathermy (SWD): continuous or pulsed. Little evidence.
• UV: UVC for infected wounds.
• Whirlpool: potential damage to healing granulation tissue.
• Vacuum-assisted closure (VAC): negative pressure to the wound through a foam pad electrode.

Question 7

Long bones length of time to become stable

Answer 7

6 to 12 weeks for lower extremity

4 to 8 weeks for upper extremity

Question 8

Classification of sprains

Answer 8

• Grade I: mild; partial tear; local tenderness and swelling but no instability.
• Grade II: moderate; full tear; considerable damage with many torn fibers, resulting in some instability.
• Grade III: severe; tear that involves bone avulsion; total severance of the ligament; surgical repair may be performed.

Question 9

Ligament healing phases

Answer 9

• Phase I: up to 48h after injury.
• Phase II: 48h to 72h.
• Phase III: about a year.