Phases of Wound Healing

Question 1

List the phase of normal wound healing.

Answer 1

1. Inflammatory Phase (1-10days)
2. Proliferation Phase (3-21 days)
3. Maturation Phase (7 days to 2 years)

Question 2

What occurs during inflammatory phase?

Answer 2

1. Platelet activation/clotting cascade to return to hemostatsis
2. Debris/Necrotic tissue removed & bacteria killed by MAST cells, neutrophils, and leukocytes

Question 3

What is the end result of phase I?

Answer 3

1. Clean wound bed signals tissues restoration and permanent repair processes begin

Question 4

How soon does Re-epithelialization begin?

Answer 4

usually within 24 hours at the wound borders

Question 5

How early are visible signs observable?

Answer 5

Three days after injury (you will start to notice healing)

Question 6

What happens during the proliferative phase?

Answer 6

1. Capillary buds and granulation tissue begin to fill the wound bed which create support structure for migration of epithelial cells
2. keratinocytes, endothelial cells, and fibroblasts are active —Collagen matrix is formed

Question 7

In what phase is skin integrity restored?

Answer 7

Proliferative Phase

Question 8

How does wound closure occur?

Answer 8

Wound close occurs thru epilthelialization and wound contraction

Question 9

What occurs during the maturation phase?

Answer 9

Fiber reorganization and contraction shrink and thin scar

Question 10

What color is an immature scar?

Answer 10

Red, raised and rigid

Question 11

What color is a mature scar?

Answer 11

Pale, flat and pliable

Question 12

How is scar tissue remodeled and strengthened in the maturation phase?

Answer 12

This occurs through the processes of collagen lysis and synthesis

Question 13

Newly repaired tissue has approximately ____% of pre-injured tensile strength and should be protected to prevent re-injury

Answer 13

15%

Question 14

Over time tensile integrity may progress to as much as ____% of tensile strength.

Answer 14

80%

Question 15

_______ scarring can significantly impact maturation phase progression

Answer 15

Hypertrophic scarring

Question 16

Hypertrophic scarring without burn will typically azure within ____ to ____ weeks

Answer 16

4 to 8 weeks

Question 17

Hypertrophic scarring with burns may take up to ______ years to reach maturity

Answer 17

2 years

Question 18

What can be expected during the Inflammatory phase?

Answer 18

Periwound edema, erythema, and drainage

Question 19

If fluid occurs at the wound site, what is this known as?

Answer 19

Plus

Question 20

True or false: during the inflammatory, oxygen is increased to keep phagocytes cells alive and functioning

Answer 20

True

Question 21

What happens if the inflammatory process is interrupted or delayed?

Answer 21

chronic inflammation can result that may last months to years

Question 22

What do fibroblasts secrete during the proliferative phase?

Answer 22

Fibroblasts secrete collagen

Question 23

In what phase does angiogenesis occur (née blood vessel growth from endothelial cells)?

Answer 23

Proliferation phase

Question 24

True or False: Granulation: new reddish, slightly bumpy tissue

Answer 24

True

Question 25

when does maturation begin?

Answer 25

Remodeling of new tissue begins while granulation tissue is forming during the proliferative phase

Question 26

What type of collagen does epithelial cells differentiate into?

Answer 26

Type I Collagen

Question 27

True or false: A decrease in oxygen availability in a wound results in increased likelihood of infection

Answer 27

True

wound tissue oxygenation is a sensitive indicator for risk of post-op infection

Question 28

True or false: the presence of edema and necrotic tissue can make it difficult for oxygen to reach the wound.

Answer 28

True; this is why compression and debridement are important components of wound management

Question 29

Explain Healing by Primary Intention

Answer 29

• occurs in acute wounds with minimal tissue loss

- Smooth clean edges are reapproximated and closed with sutures, stapes, or adhesives to facilitate re-epthelialization

Question 30

Wounds healing by primary intention typically have _____ scarring and heal quickly in an uncomplicated and orderly progression

Answer 30

Minimal scarring

Question 31

What kind of wounds also heal by primary intention with epithelial migration over the wound bed which is frequently completed in 72 hrs?

Answer 31

Superficial partial-thickness wounds, such as abrasions or blisters

Question 32

Describe Secondary intension

Answer 32

Wounds close on their own without superficial closure

Question 33

What are some characteristics of wounds that are left to heal by secondary intention?

Answer 33

Necrotic , irregular or non viable wound margins that can’t be reapproximated, infection or debris contamination heal by secondary nature

Question 34

During Secondary Intention, a layer of __________ tissue will fill the wound bed to the level of the surrounding skin, with closure occurring by wound contraction and scar formation

Answer 34

Granulation tissue

Question 35

True or False: wounds healing by secondary intention require ongoing wound care and have significantly larger scars than those healing by primary intention

Answer 35

True

Question 36

What pathology are associated with wounds that heal via secondary intention?

Answer 36

1. Diabetes
2. Ischemic conditions
3. Pressure damage
4. Inflammatory disease

Question 37

What is meant by tertiary intention healing (also referred to as delayed primary intention)?

Answer 37

1. wounds at risk for developing complications (sepsis or dehiscence) may be left open
2. Once risk factors have been alleviated the wound is closed by primary intention