Integ. Lecture 2 Test 1 Flashcards
What happens in the hemostasis phase in normal wound healing?
Blood clots form
Bleeding stops
Blood clot is broken down
How long does the hemostasis phase last in normal wound healing?
0-2 minutes
should be in full production by 2 hours
What happens in the inflammatory phase of normal wound healing?
Vascular
Exudate
Reparative
What happens in the vascular stage of the inflammatory process?
leakage fluid
proteins into wound
brings in allow needed structures to survive
What happens in the Exudate stage of the inflammatory phase?
Neutrophils come first
begin clean up
battle foreign debris and bacteria
What happens in the Reparative stage of the inflammatory process
Macrophages come in
wound healing begins*****
Battle bacteria and dead cells
Begin to lay down new tissue
What happens in the proliferative/epithelialization phase and when does it start?
starts around 2 days to 2 weeks
Granulation
angiogenesis (new blood cells)
New ECM (extra cellular matrix)
-Fibroblasts, new vessels, and collagen
Contraction via myofibroblasts
Epithelialization
How long does the inflammatory phase last?
0-2 days
What happens in the remodeling phase?
Type 3 collagen to type 1 collagen
Decrease in vascular need=pink, turning to white
+3 year process of change
How long does the remodeling phase last?
2 year to 2 weeks (toughening the skin)
T/F Any acute injury beyond the epidermis and through the BMZ causes bleeding?
TRUE
T/F Overlapping occurs during the different phases of normal wound healing?
TRUE
What helps to stop the bleeding of the a wound during the hemostasis phase?
Aggregation and activation of platelets
What type of cells release clotting factors?
Injured
What does a blood clot consist of?
Fibrin
Aggregated platelets
Blood cells
Hemostasis is further achieved by a brief period of _________ to the injured area
Vasoconstriction
What is the purpose of the clot?
- Seals disrupted vessels to control blood loss
- Provides a temporary bacterial barrier
- Provides a reservoir of growth factors
- Provides an interim matrix that serves as scaffolding for migrating cells
What is the process of breaking down a clot?
Fibrinolysis
What happens 10-15 minutes after tissue injury in the inflammatory phase?
Vasoconstriction subsides
Vasodilation and cell permeability increases
Chemoattraction by damaged cells and platelets attract leukocytes to clean up the area
First cells to arrive in the new wound are?
Neutrophils
—Present within minutes of the injury and dominate the area for 2-3 days
Primary function of neutrophils?
Remove bacteria and foreign debris via phagocytosis
After neutrophils arrive to the injured site what cells come in next?
Macrophages
What is the role of macrophages?
finishing bacteria and breaking down damaged tissue removal
Damaged cells are replaced
What is the process that occurs during the proliferative stage?
Granulation
Angiogenesis
Wound Contraction
Epithelialization
What happens during the granulation phase in proliferative phase?
Fibroblasts and capillary buds develop at the edges of the wound and gradually advance toward the center forming a bed of granulation (from the edges to the middle)
When does the granulation phase happen? (how many days out)
3-4 post injury after the inflammatory phase subsides
What affects granulation tissue formation?
Perfusion status
O2 levels
Nutritional status
Glucose levels
What happens in the angiogenesis phase of proliferative?
New extra cellular is formed by collagen fiber deposition and new capillary loops
What are the two mechanism angiogenesis occurs by?
Production of new vessels by local endothelial cells
Recruitment of circulating stem progenitor cells (starts new cells spontaneously)
T/F Contraction of a wound happens when the force pulls the edges of the wound together so the granulation tissue and the new epithelial cells don’t have to travel as far
TRUE
T/F the epithelialization and contraction happen at the same time in the proliferative phase?
TRUE
What type of cells form around the edges of the wound and migrate inward?
Basal Cells
What is contact inhibition?
when epithelial cells moving across a wound bed come in contact with other epithelial cells
Ceases migration of epithelial cells across a wound bed
New skin is ___% as strong as original tissue
15%
As the new skin becomes stronger it is around ___% as strong as the original skin?
80%
*Never will be as strong as it was
What phase completes the last wound healing process?
Remodeling phase
What are the 3 types of wound closure?
- Primary
- Secondary
- Tertiary
What is the type of wound closure that is the result from a severe infection?
Tertiary
What type of wound closure is when wound edges are approximated and secured with sutures, stapes, glues?
Primary
What type of wound closure results in the smallest scars?
primary
What type of wound closure is characterized by prolonged periods of inflammatory and proliferative phases?
Secondary
What type of wound closure benefits from skin grafts/flaps, substitutes or other surgical interventions?
Secondary
What type of wound closure benefits from negative pressure wound therapy
Tertiary
What are the 4 types of exudate?
- Serous
- Purulent
- Fibrinous
- Hemorrhagic
What is another name for exudate?
Drainage
T/F Purulent exudate is very common in a venous ulcer?
FALSE–Serous exudate
What type of exudate is a liquid that is slightly thicker than water and is light yellow?
Serous
What type of exudate is a good clinical indicator that there is an infection present?
Purulent
What type of exudate can become adherent to the wound bed?
Fibrinous
What type of exudate is red, thick drainage?
Hemmoragic
What type of exudate has the sign of infection or trauma to the area causing capillaries to break down and bleed spontaneously?
Hemmoragic
What type of exudate is reddish, thin, and watery drainage?
Sanguineous
What type of exudate occurs with trauma to blood vessels (can occurring during injury or the healing process)?
Sanguineous
What type of exudate is clear, pink, thin, and watery drainage?
Serosanguineous
What type of combination exudate is normal to see in wound healing ?
Serosanguineous
What type of exudate is yellowish and cloudy?
Seropurulent
What type of combination exudate is a good sign of wound infection?
Seropurulent
What type of exudate is dark red and viscous?
Hemopurulent
What type of contains bacteria, inflammatory cells, and tissue that is dead or dying?
Hemopurulent
What does partial thickness wound depth include?
Partial loss of dermal tissue that is confined to epidermis and superficial dermis
What does full thickness wound depth include?
involves total loss of dermal tissue that may involve deeper tissues (muscles, bone, subcutaneous)
T/F In an acute wound it generally moves rapidly and predictably through the healing process?
TRUE
What are chronic wounds frequently caused by?
- Vascular compromise
- chronic inflammation
- repetitive trauma to injured tissue
which wound results in less durable closure? (acute/chronic)
chronic
What are acute wounds caused by?
trauma or surgery
What are 7 factors that influence wound healing?
- Level/presence of infection
- Size of wound (amount and depth of tissue involved)
- Location
- Type of wound
- Amount of available blood
- Co-morbidities
- Nutrition
