Week 8 - Wound Healing Flashcards

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1
Q

How many years does it take for a scar to reach its steady state?

A

2 years

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2
Q

What % of final strength does a wound have at 3 weeks?

A

Only 20%

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3
Q

What are some factors that may delay wound healing?

A
  • Infection
  • Presence of foreign body
  • Diabetes
  • Anaemia
  • Obesity
  • Immobility
  • Poor nutrition
  • Zinc deficiency
  • Age - slower healing in elderly patients
  • Incontinence for sacral wounds
  • Trauma, including artefact
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4
Q

What drugs can delay wound healing?

A
  • Oral steroids
  • Anticoagulants
  • Retinoids
  • Immunosuppressants
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5
Q

What is this and what bugs commonly cause it?

A

An infected wound

  • Staph Aureus, Strep A/B orG
  • Occasionally Pseudomonas
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6
Q

What wound is this?

A

A necrotic wound

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7
Q

What wound is this?

A

A Granulating Wound

  • A red and well vascularised wound
  • White/pink epithelial tissue coming in from the edges and in islands.
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8
Q

What wound is this?

A

A Sloughy Wound

  • A yellow/cream exudates consisting of dead cells and protein.
  • Appropriate dressings will help reduce excess exudate.
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9
Q

What is the difference between a keloid scar and an hypertrophic scar?

A

Keloids are thicker and extend beyond the edge of the wound.

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10
Q

What is the difference between primary and secondary intention healing?

A
  • Primary intention - wound is sutured closed.
  • Secondary intention - heals without closure.
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11
Q

Why do people get keloid scars?

A
  • Genetic predisposition (family history)
  • Environmental factors
  • Tension on the scar site.
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12
Q

What are some risk factors for keloid scars?

A
  • Young age (10-30 years)
  • Familyhistory
  • African-American skin (15-20x more prone)
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13
Q

What are some treatment options for keloid scars?

A
  1. Remove the keloid lesion- surgery & radiotherapy is the gold standard.
  2. Decrease symptoms and bulk.
    • Steroid injections
      • Triamcinolone 10mg/ml
      • Review at 6 weeks to decide if more needed.
    • Massage- 10 minutes per day.
    • Steroid tape.
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14
Q

When investigating a leg ulcer, what should you do?

A
  • Document the size, site etc.
  • Doppler - if <0.8 means arterial disease.
  • Swab for infection
  • Consider XR or MRI scan if osteomyelitis suspeced.
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15
Q

What is the treatment for arterial leg ulcers?

A
  • Stop smoking
  • Exercise
  • Consider vascular surgery
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16
Q

What is the treatment for venous leg ulcers?

A

Sustained graduated compression

17
Q

What is the treatment for skin surrounding the wound?

A
  • Emollients
  • Topical corticosteroids if dermatitis
  • Consider patch test if the dermatitis isn’t responding to patch tests.
18
Q

Venous ulcers are the most common leg ulcers. What are some rarer causes?

A
  • Rheumatoid arthritis
  • Physical trauma
  • Radiation
  • Vasculitis
  • Infection -mycobacterial, syphilis, yaws, Buruli.
  • Neuropathy
  • Malignancy - SCC or BCC
    • Evolving ulcers can develop into SCC - Marjolin’s ulcers.
  • Inflammatory -pyoderma gangrenosum, necrobiosis lipoidica.
19
Q
A