wound healing Flashcards

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1
Q

in what order do cells arrive at wound

A

PMNs, Macrophages, Lymphocytes, Fibroblasts

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2
Q

which growth factor can be applied medically?

A

PDGF

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3
Q

what grows during the proliferative phase of healing

A

provisional matrix of fibrin, angiogenesis driven by hypoxia, collagen depostion in final matrix

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4
Q

what happens to collagen composition during remodeling phase

A

content levels off. Continues to be synthesis and degradation

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5
Q

rate of epithelialization depends largely on ___. Occurs starting at ___

A

health of underlying tissue (healthy dermal bed). Always heal from edges

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6
Q

three main causes of scar

A

tension, inflammation (elderly=prettier scars), genetics (AA-keloid, Asian-hypertrophic scar

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7
Q

hypertrophic scar vs keloid

A

hypertrophic- never extends beyond original borders, Keloid- grows beyond boundaries

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8
Q

what can be done in surgery to prevent scarring

A

avoid cautery, careful with forceps, proper sutur

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9
Q

how is open wound healing different?

A

spatial separation of events: leading edge has inflamm, behind is proliferation, behind is scar and remodeling

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10
Q

where is wound contraction more likely

A

loose-skinned areas (not lower extremities)

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11
Q

four most likely causes of problem wounds

A

age, ischemia, eschemia-reperfusion injury, colonization (BIOFILM)

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12
Q

affect of aging on healing

A

less inflammation makes it more difficult to heal. decreased proliferation. Decreased ability to survive stressors like hypoxia and toxins. weaker scars due to less collagen

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13
Q

Can most old people heal most wounds

A

yes. Aging shows up when ischemia or infection is superimposed on injury

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14
Q

How do you ensure maximal perfusion of wound and why

A

wounds are always hypoxic. elevate to avoid edema, offload, debride, pain control, stay warm

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15
Q

best way to avoid reperfusion injury

A

offloading

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16
Q

area of tissue supplied by a given artery

A

angiosome

17
Q

bioburden

A

sum of metabolic demand placed on wound by bacteria

18
Q

How does biofilm affect healing? How long does it take to develop

A

freezes wound healing progress in state of low grade inflammation. As little as a day

19
Q

how does amount of exudate change management

A

you have to select dressing that will keep wound moist but not too moist.

20
Q

why do diabetic foot wounds not heal. What can help?

A

decreased compensatory angiogenesis. (less VEGF, eNOS). Offloading is essential

21
Q

VAC or Negative pressure wound therapy: uses

A

to decrease edema, to improve perfusion, remove exudae, bring wound together. NOT to fully close wound

22
Q

what can be used for broad-specturm antimicrobial stuff

A

silver