Module 2: Wound Healing

Question 1

What is a wound?

Answer 1

Any disruption of the layers of the skin and underlying tissues

Question 2

What are 6 different varieties of WOUNDS?

Answer 2

• Pressure
• Venous
• Arterial
• Diabetic or Neuropathic
• Incisional dehiscence
• Trauma (includes superficial tear)

Question 3

The 3 layers of the skin are…

Answer 3

…EPIDERMIS, DERMIS and SUBQ

Question 4

What is considered a SUPERFICIAL WOUND?

Answer 4

A WOUND of the EPIDERMIS and/or DERMIS

Question 5

Through what process does a SUPERFICIAL WOUND heal?

Answer 5

RE-EPITHELIALIZATION

Question 6

T or F:

WOUNDS of the EPIDERMIS and/or DERMIS take longer to heal than those involving the SUBQ tissue

Answer 6

F, SUBQ takes longer

Question 7

Through what process are WOUNDS beyond the DERMIS healed?

Answer 7

SCAR-FORMATION

Question 8

What are the 3 intentions by which WOUNDS are healed?

Answer 8

1) PRIMARY INTENTION
2) SECONDARY INTENTION
3) TERTIARY INTENTION

Question 9

Explain PRIMARY INTENTION

Answer 9

Wounds that are surgically closed or approx. by

sutures/staples

Question 10

Explain SECONDARY INTENTION

Answer 10

Wounds that have been left open to heal by scar tissue formation

Question 11

Explain TERTIARY

Answer 11

Wounds that are intentionally opened for a while, then closed surgically at a later date (treated for infection before surgical closure).

Question 12

What is the number 1 type of WOUND that you will see in acute care?

Answer 12

SECONDARY INTENTION

Question 13

What are 5 examples of SECONDARY WOUNDS?

Answer 13

• Pressure
• Venous
• Arterial
• Diabetic or Neuropathic
• Surgical dehiscence

Question 14

“The healing process” is also known as..?

Answer 14

EPITHELIALIZATION

Question 15

What are the 4 trajectories of healing

Answer 15

1) HEMOSTASIS
2) INFLM
3) PROLIFERATION
4) REMODELLING

Question 16

What will happen to the WOUND if it does not go through all 4 of the trajectory stages?

Answer 16

It will not close

Question 17

Does HEMOSTASIS happen quickly or slowly?

Answer 17

Quickly, stat after bleeding begins

Question 18

What does a FIBRIN CLOT do?

Answer 18

Seals off the bleed

Question 19

What 2 substances are important for the formation of a CLOT?

Answer 19

1) CALCIUM

2) VIT K

Question 20

What might cause a failure to CLOT?

Answer 20

• Certain meds (anticoagulants)

- Low PLATELET count

Question 21

When does INFLM occur?

Answer 21

After bleeding is controlled, can last up to 4 days

Question 22

What is the focus during the INFLM stage?

Answer 22

To clean the WOUND bed by breaking down bacteria, foreign debris and damaged tissue

Question 23

4 characteristics of INFLM:

Answer 23

1) ERYTHEMA (redness)
2) INDURATION (excess of fibrous elements in tissue)
3) Heat
4) Pain

Question 24

What factors delay INFLM?

know 3 or 4

Answer 24

• Steroid meds
• chemotherapy
• advanced age
• diabetes mellitus
• necrotic tissue in wound bed
• foreign bodies
• wound infection

Question 25

What factors prolong INFLM?

know at least 3

Answer 25

• Repeated pressure
• trauma
• presence of necrotic tissue
• uncontrolled infection
• foreign bodies (ex: staples).

Question 26

When does PROLIFERATION start? What is the duration?

Answer 26

Starts after INFLM - 4 days, continues until 21 days

Question 27

What happens during PROLIFERATION?

Answer 27

Growth and regeneration of cells, edges of the WOUND begin to contract

Question 28

What effect does malnutrition have on healing?

Answer 28

It prolongs healing d/t lack of nutrients

Question 29

How long can REMODELLING take?

Answer 29

up to 2 years after closure of the WOUND

Question 30

What is the role of COLLAGEN is REMODELLING?

Answer 30

It strengthens the WOUND

Question 31

Why is a WOUND susceptible to further damage, even after its been closed?

Answer 31

Because SCAR TISSUE is only 80% as strong as normal tissue

Question 32

What factors pose the most risk to further damage on an old WOUND?

Answer 32

Pressure and trauma