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Integumentary > Wound Healing > Flashcards

Wound Healing Flashcards

1
Q

What are the phases of wound healing?

A
  • hemostasis
  • inflammation
  • proliferation
  • remodeling (maturation)
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2
Q

What is the timeframe of each phase of wound healing?

A
  • hemostasis: < 1 hour
  • inflammation: 4-6 days
  • proliferation: 4 - 24 days
  • remodeling (maturation): 21 days - 2 years
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3
Q

What cells peaks during the inflammation phase?

A

Neutrophils

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4
Q

What cells peaks during proliferation phase?

A

macrophages

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5
Q

What cells occur during maturation?

A
  • Fibroblasts
  • Lymphocytes
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6
Q

What does hemostasis initiate?

A

wound healing cascade

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7
Q

What is the tissue injury cascade?

A
  • Platelet activation
  • Activation of clotting cascade
  • Complement cascade (fibrinogen –> fibrin)
  • Release of chemicals that promote inflammation
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8
Q

What is the main function of hemostasis?

A

coagulation & secretion of growth factors

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9
Q

What are the 3 stages of the inflammatory phase of wound healing?

A
  • Vascular stage
  • Exudate stage
  • Reparative stage
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10
Q

What occurs during the vascular stage of the inflammatory phase?

A
  • Hyperemia
  • 5 cardinal signs of inflammation
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11
Q

What is hyperemia?

A

excess blood in vessels supplying an organ or other part of the body

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12
Q

What are the 5 cardinal signs of inflammation?

A
  • Edema
  • Loss of function
  • warmth
  • redness
  • pain
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13
Q

What is included in the exudate stage of the inflammatory phase?

A
  • serous
  • purulent
  • fibrinous
  • hemorrhagic
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14
Q

What does serous wound mean?

A

clear fluid like what may be seen in a blister

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15
Q

What does purulent wound mean?

A

pus which means infected

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16
Q

what does fibrinous wound mean?

A

fiber inside

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17
Q

what does hemorrhagic wound mean?

A

bleeding

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18
Q

what occurs in the reparative stage of the inflammatory phase?

A

phagocytosis with true wound healing beginning

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19
Q

what is the main function of the inflammatory phase?

A

remove debris

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20
Q

during the inflammatory phase of wound healing how does an increase in vascular permeability and vasodilation increase?

A

mast cells do this via degranulation and production of histamines

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21
Q

During the inflammatory phase what does an increase in vascular permeability and vasodilation allow?

A

allows for neutrophils & macrophages to migrate

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22
Q

During the inflammatory phase of wound healing what cells promote growth & migration of cells for tissue repair?

A
  • neutrophils
  • macrophages
  • accumulation of lymphocytes
23
Q

During the inflammatory phase of wound healing what does neutrophils, macrophages and accumulation of lymphocytes do?
When does the highest number present?

A
  • cleanse wound of debris
  • highest number present within 24-48 hours after injury
24
Q

During wound debridement of the inflammatory phase what proteins break down damaged tissue?

A

Proteinases & collagenases

25
Q

What occurs during the proliferative phase of wound healing?

A
  • granulation
  • angiogenesis
  • contration
  • epithelialization
26
Q

What is granulation during the proliferative phase of wound healing?

A

development of new tissue (want to protect this at all costs)

27
Q

What is angiogenesis during the proliferative phase of wound healing?

A

blood vessel formation

28
Q

What is wound contraction during the proliferative phase?

A

edges of the wound contract to make the damaged area smaller

29
Q

What is wound epithelialization during proliferative phase?

A

development of the epidermis

30
Q

What is the main function of the proliferative phase of wound healing?

A
  • fibroblasts produce collagen & epithelial tissue covers the wound
  • fill & cover
  • heals from edge towards center
31
Q

What cell is involved in degradation of non-viable tissue during the proliferative phase?

A

macrophages

32
Q

What cells are involved in neovascularization during the proliferative phase?

A
  • macrophages (a little)
  • endothelial cells (capillary formation)
33
Q

What cell is involved in collagen/extracellular matrix production during the proliferative phase?

A

fibroblasts

34
Q

What cell is involved in wound contracture during the proliferative phase?

A

myofibroblasts

35
Q

What cell is involved in epithelialization during the proliferative phase?

A

epithelial cells (basal epidermal cells)

36
Q

What occurs during the remodeling phase of wound healing?

A
  • organization of collagen tissue into more definitive & finite pattern
  • increase in tensile strength (scar tissue)
37
Q

How strong can scar tissue become?

A

only about 80% of regular tissue

38
Q

How long does the remodeling phase of wound healing last?

A

2 wks - 2 years

39
Q

What is the main function of the remodeling phase of wound healing?

A

remodeling of tissue & increasing its tensile strength

40
Q

During the remodeling phase of wound healing collagen mature, what type of collagen increase?

A

Type I collagen and some type III

41
Q

Initially collagen fibers are laid down haphazardly, what happens to the fibers during the remodeling phase?

A
  • Fibers align & new collagen is laid down along lines of stress to increase tensile strength of scar
42
Q

T/F: New tissue is prone to injury

A

true

43
Q

T/F: Collagen is constantly turning over

A

true

44
Q

What is healing by primary intention?

A

Edges brought together & held there by mechanical means

45
Q

What is the preferred method of healing?

A

healing by primary intention

46
Q

When does healing begin if healing by primary intention?

A

2-3 days

47
Q

What are the benefits of healing by primary intention?

A
  • decrease risk of infection
  • decreased time to heal
  • minimal scar formation
48
Q

What is the difference between a separated or dehiscence suture?

A
  • separated if < 1 cm
  • Dehiscence if > 1 cm
49
Q

What is healing by secondary intention?

A

gradual filling of the wound with granulation tissue

50
Q

When is healing by secondary intention used?

A

large surface areas with retracted edges or when large amounts of tissue have been lost

51
Q

What are the cons of healing by secondary intention?

A
  • more easily infected
  • increased healing time
  • increased scar formation
52
Q

What is healing by delayed primary (tertiary) intention?

A

large wounds can be partially closed w/ retaining sutures or tension sutures

53
Q

Healing by delayed primary (tertiary) intention is used when?

A
  • approximating the edges puts too much strain on the periwound skin & subcutaneous tissue
  • concern for infection & drainage that needs to be removed to prevent abscess formation

Integumentary (4 decks)

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