Lecture 7 Wound Healing

Question 1

Labiales cells

Answer 1

Continually divide and replicate throughout life, replacing cells (skin, hair, nails, mucosal cells)
Cancer cells are consider led because they are constantly dividing

Question 2

Stable cells

Answer 2

Cells that are in resting stage until stimulated when they then enter the cell cycle
Ex: bone cells and hepatocytes (liver cells)

Question 3

Permanent cells

Answer 3

Cells cannot regenerate and don’t enter cell cycle
Ex: neurons and cardiac myocytes
Adult “stem cells” can be stimulated to regenerate permanent cells

Question 4

Stages of found healing (in order)

Answer 4

Hemostatis: initial respond
Inflammation: last up to 5 days
Proliferation: new tissue formation and may involve regeneration/repair with cat tissue but loss of fnc
Wound contraction and remodeling: up to 2 years

Question 5

Factors affecting healing

Answer 5

Oxygenation-red. In COPD, atherosclerosis
Circulation- red. In elderly, CHF,DM, MI
Hydration status: red. In illness
Nutrition
Age: accelerated in young but red. In elderly
Immunity: red. In Im Unicom promised patients, infection, stress
Meds- cortisone, chemotherapy

Question 6

Wound healing processes

Answer 6

1) Macrophages- dissolve clots, debris, add
2) collagen lattice forms
3) granulation tissue fills the wound
4) hypertrophic scar tissue overfills the wound
5) cicatrización (maturation) of wound may take 1-2 years. Collagen contracts and scar becomes lighter and smoother

Question 7

Resolution

Answer 7

Returning injured tissues to the original structure and function

Question 8

Repair

Answer 8

Replacement of destroyed tissues with scar tissue until they can be replaced with normal tissue

Question 9

Scar tissue

Answer 9

Composed primary of collagen to restore the tensile strength of a tissue

Question 10

Debridement

Answer 10

Cleaning up the dissolve the clots, microorganisms, ethrocytes and dead tissue cells

Question 11

Types of wound healing

Answer 11

Primary, secondary, and tertiary intention

Question 12

Primary intention

Answer 12

Wounds that heal under conditions of minimal tissue loss
A clean laceration that requires simple re-epithelialization when edges are approximated
Ex: surgical laceration

Question 13

Secondary intention

Answer 13

Ones that require a great deal more tissue replacement
A wound with a large gap in tissue, some of the tissue has been gouged out
Ex: open wound, decubitus ulcer

Question 14

Tertiary intention

Answer 14

Require more connective tissue (scar tissue) than one and two wounds
A wound with a large gap of missing tissue that has been contaminated and needs a drainage tube while healing
(Also called delayed primary intention)
Ex: abdominal wound left open to allow for drainage then later closed

Question 15

Dysfunctional healing

Answer 15

Wounds may fail to close or may be open due to poor wound healing conditions
Nonunion, dehiscence, evisceration

Question 16

Nonunion

Answer 16

Failure of adherence

Question 17

Dehiscence

Answer 17

Wound edges separate exposing underlying tissues

Opening a wound’s suture line

Question 18

Evisceration

Answer 18

Underlying for viscera are expose

Opening of wound with extrusion of tissue and organs

Question 19

What else happens in Dysfunctional healing

Answer 19

Wounds may become infected and more tissue damage may result
Abscess (walled off pocket of infection)
sinus tract (narrow tunnel forms 
cellulitis (infection)
 Necrosis and gangrene may occur

Question 20

Keloid

Answer 20

Hyperplasia of scar tissue

Question 21

Contactares

Answer 21

Inflexible shrinkage of wound tissue that pulls the edges towards the center of the wound

Question 22

Structure

Answer 22

And abnormal narrowing of tubular body passage from the formation of scar tissue

Question 23

Fístulas

Answer 23

Abnormal connection between two epithelium-lined organs or vessels

Question 24

Adhesions

Answer 24

Internal scar tissue between tissues or organs

Question 25

Dysfunction during inflammation

Answer 25

Hemorrhage 
Fibrous adhesions
Decreased blood volume
Lack of nutrients 
Infection

Question 26

Dysfunction during reconstructive phase

Answer 26

Impaired collage matrix assembly (keloid or hypertrophic scar)

Impaired epithelialization (anti inflammatory steroids, hypoxemia, nutritional def.

Wound disruption (dehiscence w/inc risk on infection)

Impaired contraction (contracture)