Phases of Wound Healing Flashcards
List the phase of normal wound healing.
- Inflammatory Phase (1-10days)
- Proliferation Phase (3-21 days)
- Maturation Phase (7 days to 2 years)
What occurs during inflammatory phase?
- Platelet activation/clotting cascade to return to hemostatsis
- Debris/Necrotic tissue removed & bacteria killed by MAST cells, neutrophils, and leukocytes
What is the end result of phase I?
- Clean wound bed signals tissues restoration and permanent repair processes begin
How soon does Re-epithelialization begin?
usually within 24 hours at the wound borders
How early are visible signs observable?
Three days after injury (you will start to notice healing)
What happens during the proliferative phase?
- Capillary buds and granulation tissue begin to fill the wound bed which create support structure for migration of epithelial cells
- keratinocytes, endothelial cells, and fibroblasts are active —Collagen matrix is formed
In what phase is skin integrity restored?
Proliferative Phase
How does wound closure occur?
Wound close occurs thru epilthelialization and wound contraction
What occurs during the maturation phase?
Fiber reorganization and contraction shrink and thin scar
What color is an immature scar?
Red, raised and rigid
What color is a mature scar?
Pale, flat and pliable
How is scar tissue remodeled and strengthened in the maturation phase?
This occurs through the processes of collagen lysis and synthesis
Newly repaired tissue has approximately ____% of pre-injured tensile strength and should be protected to prevent re-injury
15%
Over time tensile integrity may progress to as much as ____% of tensile strength.
80%
_______ scarring can significantly impact maturation phase progression
Hypertrophic scarring
Hypertrophic scarring without burn will typically azure within ____ to ____ weeks
4 to 8 weeks
Hypertrophic scarring with burns may take up to ______ years to reach maturity
2 years
What can be expected during the Inflammatory phase?
Periwound edema, erythema, and drainage
If fluid occurs at the wound site, what is this known as?
Plus
True or false: during the inflammatory, oxygen is increased to keep phagocytes cells alive and functioning
True
What happens if the inflammatory process is interrupted or delayed?
chronic inflammation can result that may last months to years
What do fibroblasts secrete during the proliferative phase?
Fibroblasts secrete collagen
In what phase does angiogenesis occur (née blood vessel growth from endothelial cells)?
Proliferation phase
True or False: Granulation: new reddish, slightly bumpy tissue
True
when does maturation begin?
Remodeling of new tissue begins while granulation tissue is forming during the proliferative phase
What type of collagen does epithelial cells differentiate into?
Type I Collagen
True or false: A decrease in oxygen availability in a wound results in increased likelihood of infection
True
wound tissue oxygenation is a sensitive indicator for risk of post-op infection
True or false: the presence of edema and necrotic tissue can make it difficult for oxygen to reach the wound.
True; this is why compression and debridement are important components of wound management
Explain Healing by Primary Intention
- occurs in acute wounds with minimal tissue loss
- Smooth clean edges are reapproximated and closed with sutures, stapes, or adhesives to facilitate re-epthelialization
Wounds healing by primary intention typically have _____ scarring and heal quickly in an uncomplicated and orderly progression
Minimal scarring
What kind of wounds also heal by primary intention with epithelial migration over the wound bed which is frequently completed in 72 hrs?
Superficial partial-thickness wounds, such as abrasions or blisters
Describe Secondary intension
Wounds close on their own without superficial closure
What are some characteristics of wounds that are left to heal by secondary intention?
Necrotic , irregular or non viable wound margins that can’t be reapproximated, infection or debris contamination heal by secondary nature
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
Granulation tissue
True or False: wounds healing by secondary intention require ongoing wound care and have significantly larger scars than those healing by primary intention
True
What pathology are associated with wounds that heal via secondary intention?
- Diabetes
- Ischemic conditions
- Pressure damage
- Inflammatory disease
What is meant by tertiary intention healing (also referred to as delayed primary intention)?
- wounds at risk for developing complications (sepsis or dehiscence) may be left open
- Once risk factors have been alleviated the wound is closed by primary intention
