Inflammatory Response & Wound Healing Flashcards
Three Overlapping Phases of Wound Healing
Inflammation, Proliferation (Epithelialization), & Remodeling
Inflammatory Phase
Essential for healing. 2-5 days
Repair Phase
2 days - 3 weeks
Remodeling Phase
3 weeks - 2 years
Inflammation
Initial healing, remove foreign agents, vascular/cellular/homeostatic immune responses
4 Cardinal Signs of Inflammation
Redness, Swelling, Pain, & Warmth
Q 10 Effect
For every 1 deg Celsius rise in body temperature = 10-13 times increase in metabolic activity
Loss of Function
Due to: pain causing reflex guarding, increased swelling, restricted motion, & increased pressure
Tissue Hypoxia
Damaged vessels less effective in oxygen delivery
Chemotaxis
Attraction of WBCs to area
Margination
WBCs adhere to capillary wall
Diapedesis
Passage of WBCs through cell membrane wall
Defense against Microorganisms
Epithelium, Neutrophils & Macrophages, & T & B Cells
First Line of Defense
Skin and Mucous Membranes (Mechanical & Chemical Barriers). Forming protective wall & immune mechanisms.
Neutrophils
First line of defense 7-12 hours, attract mesenchymal cells which are precursors to fibroblasts (lay down collagen). Most phagocytic of WBCS along with macrophages. Primary responsible for cleansing wound.
Fibroblasts
Put down new collagen
Macrophages
Second line of defense, form lysosomes which further the phagocytosis; pus is the end result
B-Cells
Do not attack pathogens, produce antibodies that attack pathogens
T-Cells
Attack pathogens more directly
Contraction
Wound edges pull together
Granulation
Fibroblast lay down new collagen, defects filled and new capillaries are formed. Pink buds.
Hypogranulation
Absence of a successful proliferation phase. Insufficient granulation tissue to fill wound defect.
Hypergranulation
Granulation continues after the wound defect has been filled.
Hypertrophic Scarring
Over production of immature collagen.
Keloids
Result from excessive immature collagen synthesis
Dehiscence
Separation of wound margins due to insufficient collagen production or tensile strength
Wolfe’s Law
Tissue respond to stresses placed on it. BONE
Davie’s Law
Tissues respond to stresses placed upon it. SOFT TISSUE
Transudate
Normal passage of fluid in the body
Exudate
Abnormal fluid passage or build up. Example: Pus.
Serous
Clear, watery. Example: Blister
Sanguineous
Tinge of Red, Thin
Purulent
Creamy, Thick
Primary Intention
Occurs in wounds whose edges are closely related or whose edges have been approximated by sutures or staples. Tend to heals longer time period, scar formation. Preferred and most effective method of healing.
Redness (Rubor)
Dilatory response caused by release of chemical mediators.
Vasodilation
Is to allow WBCs to enter injured area.
Swelling
Cell permeability changes, interstitial osmotic pressures increases.
Pain
Nerve ending irritation, lowers threshold of nococeptors.
Cell anoxia
Cells dying due to lack of oxygen.
Warmth
Increased blood flow, increased chemical and metabolic activity.
Sebum
Oil skin & hair. Pathogen inhibiting agents.
Mucus
Pathogens may stick and be swept away. Viscosity inhibits microbe movements.
Enzymes
Tears. May hydrolysis pathogens.
Hydrochlorid Acid
Stomach acid. May destroy pathogens.
Sweat, tears, saliva
Dilution and washing action. Inhibit microbial growth.
Proliferation Phase
Contraction, Granulation, Epitheiliazation
Epithelialization
Epithelial cell migration towards the center of the wound from edges. Contact inhibition stops migration.
Remodeling
Blends with repair phase. New collagen forms which increases wound strength.
Closed
The epithelial integrity has been restored
Healed
After it has been resurfaced and tissue strength approaches normal.
Contracture
Shortening of scar tissue resulting in deformity. Likely to occur in wounds crossing a joint (burns).
Second Intention
Occurs in wounds with large surface areas, distracted edges, or large amount of tissue loss. Heal by gradual filling of the wound with granulation material. Infected more easily. Extended healing time, excessive scar formation.
