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ABSITESLAYER > Wound Healing > Flashcards

Wound Healing Flashcards

1
Q

Name the 3 phases of wound healing:

A

Inflammation (1–6 days), proliferation (3 days–3 weeks), maturation (3 weeks–1 year)

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2
Q

Name several factors that can inhibit wound healing:

A

Diabetes, infection, ischemia, malnutrition, radiation, steroids, neoplasia, anemia

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3
Q

What are the optimal nutrition parameters?

A

Albumin >3 g/dL and prealbumin >16 mg/dL

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4
Q

What is primary wound closure (primary intention)?

A

Immediate closure of a wound with suture or staples

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5
Q

Most important factor in healing closed wounds by primary intention:

A

Tensile strength

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6
Q

What is the most important layer to close for strength in skin lacerations?

A

Dermis

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7
Q

How long does it take a surgical incision to become “watertight”?

A

24 to 48 hours

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8
Q

What is secondary wound closure?

A

Leaving a wound open and allowing it to heal by granulation, contraction, and epithelialization over time

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9
Q

Most important factor in the healing of open wounds by secondary intention:

A

Epithelial integrity

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10
Q

What causes contraction in wounds healing by secondary intention?

A

Myofibroblasts

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11
Q

What is delayed primary closure?

A

Closing a wound several days (3–5 days) after incision

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12
Q

Rate of regeneration of a peripheral nerve:

A

1 mm/d or 1 in./mo

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13
Q

Rate of epithelialization:

A

1 to 2 mm/d

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14
Q

The strongest layer of the bowel:

A

Submucosa

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15
Q

The time period that a small-bowel anastomosis is at its weakest:

A

3 to 5 days

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16
Q

Name the 2 major events in the process of epithelialization:

A

Migration and mitosis

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17
Q

Name the process by which keratinocytes pile up on top of each other at the leading edge of a migration and tumble forward over the top of the heap:

A

Epiboly

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18
Q

What cell is the most essential for wound healing?

A

Macrophage

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19
Q

This cell is responsible for the movement and contraction of wound edges:

A

Myofibroblast

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20
Q

Name the order of arrival of the different cells involved in wound healing:

A

Platelets (not a true cell)

Neutrophils (predominant cell type from day 0–2)

Macrophages (predominant cell type from day 3–4)

Fibroblasts (predominant cell type from day 5 and so on)

Lymphocytes

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21
Q

α Granule contains:

A

Platelet factor 4, β-thrombomodulin, PDGF, and TGF-β are contained in this type of platelet granule

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22
Q

Dense granule contains:

A

Adenosine, serotonin, and calcium

23
Q

Name the predominant cell during days 0 to 2 of wound healing:

A

Neutrophils

24
Q

Name the predominant cell during days 3 to 4 of wound healing:

A

Macrophages

25
Q

Name the predominant cell present after day 5 of wound healing:

A

Fibroblasts

26
Q

When does the maturation phase usually begin?

A

∼3 weeks after the injury

27
Q

What is the maximal tensile strength that a wound can reach?

A

80% of original tissue strength

28
Q

Time period for maximum collagen accumulation in a wound:

A

2 to 3 weeks (mostly type III, then gets converted to type I with maturation)

29
Q

Time period for a wound to reach its maximal tensile strength:

A

8 weeks

30
Q

True or False: Denervation negatively affects epithelialization and wound contraction:

A

False; denervation has no effect on epithelialization and wound contraction

31
Q

The number of organisms/cm2 required to retard wound healing:

A

100,000 organisms/g (105 organisms/g)

32
Q

What is the generally recommended period of time to wait for scar maturation before considering scar revision?

A

12 to 18 months

33
Q

What can be given to combat the inhibitory effects of steroids on wound healing and epithelialization? Dose?

A

Vitamin A; 25,000 IU daily

34
Q

Necessary cofactor for hydroxylation and cross-linking of proline and lysine in collagen synthesis:

A

Vitamin C (deficiency causes scurvy)

35
Q

Vitamin C (deficiency causes scurvy)

A

Keloid

36
Q

Type of scar that remains confined to the boundaries of the original wound and contains an overabundance of collagen:

A

Hypertrophic scar

37
Q

The most common type of collagen is:

A

Type I collagen

38
Q

Type of collagen predominantly synthesized in the first 48 hours of a healing wound

A

Type III collagen

39
Q

Type of collagen located in skin, bone, and tendon and is the primary collagen found in a healed wound:

A

Type I collagen

40
Q

Type of collagen found in hyaline cartilage:

A

Type II collagen

41
Q

Type of collagen in arteries and dermis and is increased in wound healing:

A

Type III collagen

42
Q

Type of collagen that is predominant in the basement membrane:

A

Type IV collagen (type IV found on floor)

43
Q

Type of collagen found in the cornea:

A

Type V collagen

44
Q

Stage the pressure sore: nonblanchable erythema of intact skin:

A

Stage I (can be seen after 30 minutes, resolves after 1–2 hours)

45
Q

Stage the pressure sore: partial-thickness skin loss involving epidermis and dermis:

A

Stage II (can present as blister, forms after 2–6 hours, erythema lasts >24 hours)

46
Q

Stage the pressure sore: full-thickness skin loss with involvement of underlying subcutaneous tissue:

A

Stage III (does not extend through fascia)

47
Q

Stage the pressure sore: full-thickness skin loss with tissue necrosis or extensive destruction of underlying structures (muscle/bone):

A

Stage IV

48
Q

Areas at greatest risk for pressure sores:

A

Ischium 28%, trochanter 19%, sacrum 17%, heel 9%, occiput of scalp

49
Q

Rules of operative management for pressure sores (name 4):

A

Debride all devitalized tissue

Excise entire bursa (can use methylene blue to identify entire bursa)

Identify and remodel bony prominences

Reliable tissue coverage with appropriate flap without burning bridges for future reconstruction

50
Q

Name the amino acid that is found in every 3 residues in collagen:

A

Proline

51
Q

Name the necessary cofactors for the hydroxylation of proline:

A

Vitamin C, oxygen, iron, and α-ketoglutarate

52
Q

What enzyme is the rate-limiting step in collagen synthesis?

A

Propyl hydroxylase

53
Q

Albumin level that puts a patient at risk for poor wound healing:

A

<3.0 g/dL

54
Q

Time period to wait for chemotherapy to have no effect on wound healing:

A

14 days

ABSITESLAYER (8 decks)

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