Wound Healing

Question 1

What are the 4 main stages of wound healing?

Answer 1

Haemostasis, inflammatory, proliferative and remodelling

Question 2

What occurs in proliferation? (4)

Answer 2

Angiogenesis
Fibroplasia
Epithelialisation
Contraction

Question 3

What is angiogenesis?

Answer 3

Oxygen is critical for fibroblasts to produce collagen in order to establish granulation tissue, requires formation of new blood vessels

Question 4

What is fibroplasia?

Answer 4

Fibroblasts migrate to wound and replicate, deposit collagen, matrix depends on O2 and substrate availability as well as growth factors

Question 5

What is epithelialisation?

Answer 5

Epidermal covering, keratinocytes migrate across wound, neodermis differentiates, moist environment favoured

Question 6

What occurs during contraction?

Answer 6

Fibroblasts differentiate to myofibroblasts that produce contractile proteins, pulling edges of wound together

Question 7

When does remodelling occur?

Answer 7

3 weeks-year

Question 8

What are the main components in remodelling?

Answer 8

Formation of new granulation tissue stops, new blood vessels formed no longer required, fibrous scar formed by collagen cross-linking

Question 9

Give examples of local factors that impair wound healing?

Answer 9

Pressure, dehydration, trauma, oedema, infection, necrosis, incontinence and poor O2 delivery

Question 10

Give examples of systemic factors that impair wound healing?

Answer 10

Malnutrition, obesity, chronic disease, vascular insufficiency, immunodeficiency, smoking, stress, poor health, long term steroid use and old age

Question 11

Name therapeutic steps to promote wound healing

Answer 11

Sutures, staples, steristrips, glue, maggots and hyperbaric chambers

Question 12

List 5 repair complications

Answer 12

Wound dehiscence (deficient healing) keloid (excessive scar formation) adhesions, infection and chronic pain