Intro to Wound Healing Flashcards
layers of the skin in order
epidermis
derman-epidermal junction (aka basement membrane)
dermis
subcutaneous (aka hypodermis)
adipose tissue
muscle
bone
5 layers of epidermis
stratum corneum
stratum lucidium
stratum granulosum
stratum spinosum
straum basale
non blanchable skin
bleeding under the skin
types of cells in the epidermis
keratinocytes (squamous cells)
melanocytes
langerhans cells (immune respnse)
avascular
types of cells in the dermis
vascular and nerve supply
fibroblasts
collagen
elastin
function of epidermis
protection
vitamin D synthesis
thermoregulation
sensation
pigmentation
dermal appendages
hair follicles
sebaceous glands
sweat glands
lined with epithelial cells (epithelial islands)
skin function
provides thermoregulation
sensation
metabolism
organ of communication and identification
- injury can result in functional, physiological, body image change
capable of expression
skin Loss *****
woulds are classified by depth of tissue injury except for pressure injury
erosion **
loss of superficial epidermis, probably not bleed, redness, repair by local inflammatory response
ex: superficial burns/first degree
stage 1 pressure injury, abrasians
partial thickness skin loss ***
loss of epidermis and part of the dermis, bleed, reepithelization for repair
ex: stage 2 pressure injury, superficial and deep thickness burns/second degree, skin tears and deep abrasians
full thickness skin loss ***
loss of epidermis, dermis extending into subcutaneous/hypodermis, secondary intention repair through scar
ex: third degree burns, stage 3 and 4 pressure injury, surgical incisions, traumatic wounds
skin changes with agins
decreased
epidermal/dermal thickness
subcutaneous fat
collagen and elastin
sensation
sweat glands
circulation
mast cells
regneration
4x slower healing
acute wound
unplanned/planned event
healing proceeds in an orderly and timely fashion
surgical
abrasian/laceration
chronic wounds
exists 2 weeks or longer
does not proceed thru normal healing process
pressure ulcers
diabetic ulcers
NORMAL healing phases of wounds 4
hemostasis - to stop bleeding
inflammatory phase
proliferative phase (collagen)
maturation phase (remodeling)
granulation tissue
fibroblasts produce collagen, wound contraction
20-40% of wound will be reduced in a few weekse
epithelialization
migration of epithelial cells from wound edegs to resurface the wound
hypertrophic scarring
synthesis exceeds breakdown
contained within the site of injury, has a likelihood of lessening and improving over time
keloid scarring
can spread beyond borders of initial injury
abnormal healing responses causing scarring. Both are firm and raised scars formed by excessive collagen during healing. Both scars are raised
type of wound closure
primary intension
delayed primary
secondary intention
primary intention wound closure
surgical closure
traumatic wounds after sufficient I+ D (< hrs after injury = golden rule
incisional wounds with little tissue damage
seconday intention wound healing
spontaneous closure
partial thickness wounds heal by epithelialization/contraction
wounds with full thickness loss heal by epithelialization granulation and contractions
wounds with high bacterial count, debris, necoriss, or full thickness depth may be allowed to close spontaneously
wound bed filling with viable tissue
tertiary - delayed primary healing
surgical closure after granulation tissue has developed, planned period where wound is left open
