Second intention healing Flashcards
The key components of second intention would healing?
Granulation
Contraction
Epithelialization
How do the phases of second intention wound healing differ from first intention
Same phases but a much extended duration of cellular phase
How does contraction occur?
Myfibroblasts produce actin and fibronectin
Rate of contraction on body? on limbs?
1mm/day
0.2mm/day
4 factors affecting the rate of contraction of the skin?
Inelasticity of skin
vascular insufficiency
fewer myofibroblasts
cytokines
Rate of epitheliazation on the body? the limbs?
- 2mm/day
0. 09mm/day
3 ways to prevent exuberant granulation tissue?
Debridement
sterile dressing
pressure bandages
Describe bandage pholosiphy
pressure early is the best to limit wound size,
later it can be a catch 22. can slow healing once granulation tissue is present. but still offer mechanical protection
2 ways to manage exuberant granulation tissue once its there
sharp debridement
topical medicaments
big positives of topical medications? big disadvantages?
Owner friendly, control granulation tissue
slow contraction, slow epitheliazation
8 topical medications you can use to slow granulation tissue
Corticosteroids white wound lotion copper sulfate furacin preparation H Amnion Collagen preparations Biosyst
8 topical medications you can use to slow granulation tissue
Corticosteroids white wound lotion copper sulfate furacin preparation H Amnion Collagen preparations Biosyst
Drawback of corticosteroids
Slow epitheliazation
What is white wound lotion?
Lead acetate and zinc sulfate
Drawbacks of white wound lotion?(3)
Metabolic toxins
kill fibroblasts
slows epitheliazation
lead poisoning possibility
Drawback of copper sulfate?
Kills fibroblasts
What can you do to make fibroblasts more friendly
Mix with corn starch to dilute
What are the 2 things furacin does?
Stimulates granulation tissue production???
inhibits epitheliazation
What does furacin harbour?
harbours pseudomonas
What is preparation H
Yeast extract
What does preparation H do?
Stimulates production of granulation tissue
Slows contraction and epitheliazation
What does amnion do?
Inhibits granulation tissue
promotes epitheliazation
speeds healing
WAHOO!
What colours actually work?
Green - corticosteroids
purple - copper sulfate?
red - Amnion
What colours actually work?
Green - corticosteroids
purple - copper sulfate?
red - Amnion
collagen preparations affective?
No no hurt no benefit
What is in procine small intestinal submucosa? Promotes/
Collagen, proteoglycans, cytokines
Scaffold, healing modifier
Are split thickness skin grafts useful?
Yes inhibit granulation and promote wound contraction
