Week 2: Factors Affecting Wound Healing (Ch 3)

Question 1

What is an acute wound?

Answer 1

a wound induced by surgery or trauma in an otherwise healthy individual (progresses through normal phases of wound healing in predictable time and manner)

Question 2

What is a chronic wound?

Answer 2

a wound whose progression through healing phases if prolonged or arrested due to underlying conditions

Question 3

What does “recalcitrant” mean?

Answer 3

not obedient or not compliant

Question 4

What are deterrents to expedient wound healing?

Answer 4

1. wound characteristics
2. local factors
3. systemic factors
4. inappropriate wound management

Question 5

What are characteristics that affect rate of wound management?

Answer 5

MOI, time since onset, wound location, wound dimensions, temperature, wound hydration, necrotic tissue or foreign bodies, infection

Question 6

What is the ideal wound healing temperature?

Answer 6

37-38 C, 98.6-100.4 F (foam is best)

Question 7

What is the clinical word for a dry wound?

Answer 7

dessication

Question 8

What is the ideal amount of wound hydration?

Answer 8

moist (too dry impedes current, too wet causes maceration)

Question 9

What do foreign bodies do?

Answer 9

prolong inflammation

Question 10

What does necrotic tissue do?

Answer 10

promotes infection

Question 11

what is a normal level of microflora for cultures?

What is concerning

Answer 11

10^3 microbes per g/tissue

>10^5 = infection

Question 12

What are the signs and symptoms of infection?

Answer 12

similar to inflammation, but disproportionate to the wound

Question 13

What are the key differences for chronic wound healing?

Answer 13

senescent cells, increased number of inflammatory mediators, reduced number of tissue inhibitors of MMPs, reduced or arrested epithelialization, greater bioburden

Question 14

What are some local factors that affect wound healing?

Answer 14

circulation, sensation, mechanical stress

Question 15

What are some systemic factors that affect wound healing?

Answer 15

age, nutrition, comorbidities, medication, behavioral risk taking (alcohol, smoking)

Question 16

Tissue perfusion occurs at what level?

Answer 16

microcirculation

Question 17

What is sympathetic response?

Answer 17

vasoconstriction

Question 18

Older adults have a _______ immune response.

Answer 18

Slowed

Question 19

Older adults have a _______ collagen synthesis and strength.

Answer 19

decreased

Question 20

Older adults have epidermal and dermal _______.

Answer 20

atrophy

Question 21

Older adults have a _______ number of sweat and oil glands.

Answer 21

decreased

Question 22

Older adults have a _______ pain perception.

Answer 22

decreased

Question 23

Older adults have a _______ inflammatory response.

Answer 23

decreased

Question 24

Older adults have a _______ number of comorbidities.

Answer 24

greater

Question 25

Older adults have a _______ susceptibility of infection.

Answer 25

increased

Question 26

What happens to individuals with inadequate nutrition?

Answer 26

increased incidence of complications, delayed healing time

Question 27

Which medications mainly affect wound healing?

Answer 27

steroids at doses of >30-40 mg/day, chemotherapy, and NSAIDs

Question 28

How does alcohol abuse affect wound healing?

Answer 28

malnutrition, greater risk for injury, less likely to obtain medical assistance

Question 29

How does smoking affect wound healing?

Answer 29

decreases tissue perfusion, reduces oxygenation, delays normal cellular response

Question 30

Smoking has a _____x increased graft/flap or necrosis risk, and ______x increased infection rate

Answer 30

3, 3-5