post-surgical wound healing Flashcards
what are the 3 phases of post-surgical wound healing?
1) Inflammation
2) Fibroblastic granulation
3) Matrix formation and remodeling
what is the immediate response during healing by primary intention?
- Formation of blood clot between margins of wound and between flap and tooth or bone
the immediate clot of primary healing is composed of what?
Clot includes:
fibrin,neutrophils,platelets, red cells, cell debris, and capillaries at the edge of the wound
during healing by primary intention, what occurs within the first 24 hours?
- Neutrophils infiltrate the connective tissue
* Epithelium begins to migrate from the wound margins
during healing by primary intention, what occurs during the first 1-3 days?
- Space between the flap and tooth or bone narrows
* Epithelial cells migrate over the border of the flap, contacting the tooth
what happens during the 3-7 days after surgery during PRIMARY healing?
- Epithelial migration continues
- Neutrophils replaced by macrophages
- Blood clot is replaced by granulation tissue
- Re-vascularization begins
during healing by PRIMARY intention, the site of surgery will show the following characteristics after ONE WEEK:
- Epithelium attaches to the root
* Blood clot is replaced by granulation tissue
the granulation tissue that replaces a blood clot during PRIMARY healing is derived from what 3 sources?
derived from:
- gingival connective tissue
- bone marrow
- periodontal ligament
what are the characteristics of a wound TWO WEEKS after healing by primary intention?
- Collagen fibers are oriented parallel to tooth surface (nonfunctional)
- Union of flap to tooth is weak
- Collagen fibers are immature
during healing by primary intention, Inflammatory cells are mostly gone after what amount of time?
1 month
what changes occur after 1 month of primary healing?
- Fibroblasts proliferate, synthesize collagen
- Revascularization process regresses
- Epithelial attachment is well defined
During primary healing, the _________ will be FULLY epithelialized after ONE MONTH
gingival crevice
around the 1 month mark, there will be a Functional arrangement of ________ fibers (in healing by primary intention)
supracrestal
at what time, following surgery, will a wound healing from primary intention regain most of its original tensile strength?
2 months
When the bone is exposed by a full thickness flap, superficial bone necrosis occurs after _________ days
1 to 3 days
after bone exposure, ________ resorption follows superficial necrosis, peaking at 4 to 6 days
Osteoclastic
Typically, how much bone is lost when exposed to the oral environment?
1 mm
what should be done to ensure the best outcomes of surgical therapy?
(theres 4 things)
1) Minimize trauma to tissue
2) Minimize wound desiccation (irrigate with saline, minimize length of procedure)
3) Suture meticulously
4) Address systemic health issues
how does healing by SECONDARY intention differ from healing by primary intention?
(3 key differences)
- A more vigorous inflammatory response
- Formation of a larger volume of granulation tissue to fill the defect
- More pronounced wound contraction during healing
during wound healing, the ____________ is a major initial source of growth factors and cytokines
the blood clot
what 3 growth factors are released from a blood clot?
1) PDGF
2) EGF
3) TGF-beta
what is the effect of PDGF on wound healing?
induces:
1) fibroblast and macrophage migration
2) fibroblast proliferation
3) macrophage activation
the growth factor _______ induces epithelial proliferation
EGF
what does growth factor TGF-beta induce?
induces:
A) migration of inflammatory cells
AND
B) proliferation of fibroblasts
what factors are released by fibroblasts and macrophages?
1) TNF
2) IL-1B
what are the effects of TNF? what about IL-1B?
- TNF: activates endothelium, induces neutrophil migration
* IL-1ß: activates endothelium, induces neutrophil migration
what are the requirements for the best outcome of healing by secondary intention?
- Minimize trauma
- Preserve blood clot
- Minimize bacterial colonization of site
- Address systemic health issues
- Be aware that smoking impairs healing
what is the definition of tissue repair?
damaged tissues are replaced by tissues that don’t duplicate the function or architecture or the original tissues
what is the definition of tissue regeneration?
damaged tissues are replaced by tissues that duplicate the structure and function of the original tissues.
