Wound healing

Question 1

4 Stages of wound healing?

Answer 1

• Hemostasis: Blood clotting and initial wound closure
• Inflammation: Removal of debris and bacteria by immune cells (swollen, erythema, pain) (3-5 days)
• Proliferation (fibroplasia): Formation of new tissue and blood vessels. (2 weeks)
• Remodelling: Tissue maturation and strengthening of tissue. (6 months-2years)

Question 2

Difference between regeneration and repair?

Answer 2

• Regeneration: Scarless healing; Complete restoration of damaged tissues to original state
• Repair: Healing with scar: Restoration of damaged tissue but replaced scar tissue

Question 3

What is atypical healing?

Answer 3

• Disruption in one or more healing stages
  = Prolonged inflammation and excessive fibroblast activity.

Question 4

Difference between acute and chronic wound?

Answer 4

• Acute: Wounds that progress through normal stages of healing within predicted timeframe
• Chronic: Wounds that fail to progress through normal stages of healing and remain unhealed for an extended period. (maybe due to underlying conditions)

Question 5

What is a normotrophic scars?

Answer 5

Flat scars that are not raised nor depressed, line with surrounding skin

Question 6

Differences between immature and mature scar and their symptoms?

Answer 6

• Immature: Erythematous (due to high vascularity), raised (inflamed), firm, and itchy or painful
• Mature: White or lighter than surrounding skin (due to reduced blood supply) flattened, softened, and less symptomatic (no sensation)

Question 7

Which is likely to heal better from treatments with treatments between immature and mature scar and why?

Answer 7

Immature scar; Still likely be in remodelling phase, have vascularity, whereas mature scars are likely to be in their final remodelling phase, there fore less responsive to treatments

Question 8

Difference between hypertrophic and keloid scar?

Answer 8

• Hypertrophic: Excessive collagen deposition within wound boundaries, Red, raised, and thickened, pruritus (itchiness), erythema (redness), and discomfort.
• Keloid: Overproduction of collagen extending beyond the original wound, Larger, more irregular, often itchy or painful

Question 9

What is atrophic scar?

Answer 9

Loss of tissue resulting in depressed, sunken appearance

Question 10

What is a contracture scar?

Answer 10

Tightening of skin and underlying tissues

Question 11

What is dehisced wound?

Answer 11

Surgical wounds that have reopened along incision

Question 12

What is wide spread scars?

Answer 12

Healed to a large scar covering extensive areas, due to burns or severe trauma.

Question 13

Wound depths and their differences?

Answer 13

• Superficial: Affect epidermis
• Partial thickness: Epidermis and part of dermis
• Full thickness: Extend through dermis into subcutaneous tissue or beyond

Question 14

Triangle of wounds include observing the 3..?

Answer 14

• Wound Bed: Evaluate tissue types, necrosis or slough, infection and granulation tissue.
• Wound Edge: Assess condition of the wound margins; undermining or rolled, maceration or dehydration.
• Periwound Skin: Examine surrounding skin for signs of erythema, oedema, excoriation, hyperkeratosis, callus, and dry/eczema skin.

Question 15

Primary intention of wounds?

Answer 15

• Wound edges are brought together (e.g., sutured, stapled, or glued), allowing for a minimal gap between the tissues
• Used for wounds that have clean, cuts and surgical incisions.

Question 16

Secondary intention of wounds?

Answer 16

• Wound is left open to heal on its own, allowing granulation tissue to fill the gap, can’t be stitched due to wound being too wide
• Used when there’s tissue loss and infected/contaminated

Question 17

Tertiary intention of wounds?

Answer 17

• Wound is left open to allow any infection or contamination to clear, and then it is closed later
• Used for wounds that are high risk for infection or complications.
  risky option.

Question 18

What is slough?

Answer 18

• Dead tissue that is yellow, tan, green, or brown in colour and may be moist, loose, or stringy in appearance, often found on wound beds.
• Too much slough: mesh net, halting growth of granulation

Question 19

What is excoriation in wound?

Answer 19

Loss of superficial layer of skin due to scratching or picking

Question 20

Difference between rolled edges and undermining wound?

Answer 20

Rolled: The epidermis healing rolled edges inwards, not allowing to close the wound properly
Undermining: Wound edges rolled and tucked backwards, corneocytes redirect opposite direction causing gap between skin and granulation

Question 21

What is maceration in wound?

Answer 21

Excessive moisture
- Softening or breaking down of skin from prolonged exposure to moisture, seen around wound edges.