Module 2: Wound Healing Flashcards
What is a wound?
Any disruption of the layers of the skin and underlying tissues
What are 6 different varieties of WOUNDS?
- Pressure
- Venous
- Arterial
- Diabetic or Neuropathic
- Incisional dehiscence
- Trauma (includes superficial tear)
The 3 layers of the skin are…
…EPIDERMIS, DERMIS and SUBQ
What is considered a SUPERFICIAL WOUND?
A WOUND of the EPIDERMIS and/or DERMIS
Through what process does a SUPERFICIAL WOUND heal?
RE-EPITHELIALIZATION
T or F:
WOUNDS of the EPIDERMIS and/or DERMIS take longer to heal than those involving the SUBQ tissue
F, SUBQ takes longer
Through what process are WOUNDS beyond the DERMIS healed?
SCAR-FORMATION
What are the 3 intentions by which WOUNDS are healed?
1) PRIMARY INTENTION
2) SECONDARY INTENTION
3) TERTIARY INTENTION
Explain PRIMARY INTENTION
Wounds that are surgically closed or approx. by
sutures/staples
Explain SECONDARY INTENTION
Wounds that have been left open to heal by scar tissue formation
Explain TERTIARY
Wounds that are intentionally opened for a while, then closed surgically at a later date (treated for infection before surgical closure).
What is the number 1 type of WOUND that you will see in acute care?
SECONDARY INTENTION
What are 5 examples of SECONDARY WOUNDS?
- Pressure
- Venous
- Arterial
- Diabetic or Neuropathic
- Surgical dehiscence
“The healing process” is also known as..?
EPITHELIALIZATION
What are the 4 trajectories of healing
1) HEMOSTASIS
2) INFLM
3) PROLIFERATION
4) REMODELLING
What will happen to the WOUND if it does not go through all 4 of the trajectory stages?
It will not close
Does HEMOSTASIS happen quickly or slowly?
Quickly, stat after bleeding begins
What does a FIBRIN CLOT do?
Seals off the bleed
What 2 substances are important for the formation of a CLOT?
1) CALCIUM
2) VIT K
What might cause a failure to CLOT?
- Certain meds (anticoagulants)
- Low PLATELET count
When does INFLM occur?
After bleeding is controlled, can last up to 4 days
What is the focus during the INFLM stage?
To clean the WOUND bed by breaking down bacteria, foreign debris and damaged tissue
4 characteristics of INFLM:
1) ERYTHEMA (redness)
2) INDURATION (excess of fibrous elements in tissue)
3) Heat
4) Pain
What factors delay INFLM?
know 3 or 4
- Steroid meds
- chemotherapy
- advanced age
- diabetes mellitus
- necrotic tissue in wound bed
- foreign bodies
- wound infection
What factors prolong INFLM?
know at least 3
- Repeated pressure
- trauma
- presence of necrotic tissue
- uncontrolled infection
- foreign bodies (ex: staples).
When does PROLIFERATION start? What is the duration?
Starts after INFLM - 4 days, continues until 21 days
What happens during PROLIFERATION?
Growth and regeneration of cells, edges of the WOUND begin to contract
What effect does malnutrition have on healing?
It prolongs healing d/t lack of nutrients
How long can REMODELLING take?
up to 2 years after closure of the WOUND
What is the role of COLLAGEN is REMODELLING?
It strengthens the WOUND
Why is a WOUND susceptible to further damage, even after its been closed?
Because SCAR TISSUE is only 80% as strong as normal tissue
What factors pose the most risk to further damage on an old WOUND?
Pressure and trauma
