Wound Healing Flashcards
Sequence of body’s defense mechanism:
1) Stop the blood loss (Hemostasis)
2) Clean up pathogens and debris in the wound
3) Seal the wound against infection
4) Regenerate the natural epidermal covering
5) Repair deeper tissue damage
3 phases of wound healing:
1) Inflammation phase
2) Proliferation phase
3) Remodeling phase
Inflammation phase includes
Starts immediately after an incision is made and lasts for first 6 days
Hemostasis
Phagocytosis
Edema
Proliferation phase includes
Starts the second day after the incision is made and continues until the 22nd day
Epitheliazation
Neovascularization
Collagen synthesis
Contraction
Remodeling phase includes
Starts 21 days after the incision and may continue for 2 years
Collagen remodeling
Tensile strength
Three ways in which wounds heal
Primary union/First intention
Granulation/Second intention
Delayed primary closure/third intention
Primary/First intention features
Ideal conditions, clean incision with wound edges approximated by suture, staples, etc
Minimal tissue loss and no dead space is left as a potential for site infection
Wound margins are approximated with little drainage
Granulation/Second intention features:
Wound is debrided, cleansed and occluded- allowed to fill with granulation tissue
Infection, excessive trauma, tissue loss, or imprecise approximation of tissues causes healing by second intention
Significant tissue loss, may require grafting
Wound is left open and allowed to heal from the inner layer to the outer surface
Delayed primary closure/third intention features:
Method of repair for contaminated, dirty, infected traumatic wounds with extensive tissue loss and a high risk for infection
Suturing is delayed to wall off area of gross infection- wound is kept open to monitor!
Closed on day 3-5
Examples of primary union/first intention wounds:
Surgical incision
Simple lacerations
Examples of granulation/second intention wounds:
infected wounds, drains, trauma, tissue loss
Examples of delayed primary closure/third intention wounds:
Compartment syndrome, burns, debridement, wound disruption, excessive trauma
Characteristics of Class I clean wounds:
No inflammation encountered
No breaks in sterile technique
No hollow viscous entered
Respiratory, alimentary, genital or infected urinary tracts are not entered
Examples of class I clean wounds include:
Thyroidectomy
Mastectomy
Ganglion excision
Herniorrhaphy
Laminectomy
Characteristics of Class II clean contaminated wounds:
Nontraumatic wounds
No inflammation encountered
No breaks in sterile technique
HOLLOW VISCOUS ENTERED
RESPIRATORY, ALIMENTARY, GENITAL or URINARY TRACTS ARE ENTERED UNDER CONTROLLED CONDITIONS!
