Wound healing Flashcards
inflammation goal
Control bleeding, and fight infectious agents
During inflammation the local blood vessels reflexively
Constrict
during inflammation the platelets
Aggregate and are activated
form a plug to wall off affected area and close off lymphatic channels creating more edema
Release chemical mediators necessary for wound healing
how long after vasoconstriction does vasodilation occur
within 30 min
Localized redness, warmth, edema
Cellular response during inflammation
increased leakiness of vessel walls
It pushes polymorphonuclearneutrophils sides of the vessel walls (margination)
PMNs
The first to the site 12-24 hours
kill bacteria
clean wound
secrete matrix Metalloproteases
degrade debris
macrophages
kill pathogens
Direct the repair process
mast cells
Produce histamine and secrete enzymes to its accelerate riddance of damaged cells
angiogenesis
Formation of new blood vessels
During proliferation
granulation tissue
Fibroblast lay down extracellular matrix, and is eventually replaced by scar tissue
wound contraction
Myofibroblasts pull wound margins together
during maturation and remodeling granulation tissue must be
Strengthened and re-organized
Type three collagen is replaced by type one collagen
epithelialization
Keratinocytes and epidermal appendages multiply and migrate across wound bed
maturation and remodeling information
Epithelialization
Rapid collagen synthesis
Two years following wound closure, greatest change in the 6 to 12 months
Unable to sweat, loss of sweat glands
Less sensitive to touch and temperature
General factors to wound healing
Mechanism of onset and etiology
Time since onset, acute versus chronic
Location- Bony prominences blood supply, skin thickness
Temperature (37 to 38 Celsius is best)
wound hydration
Necrotic tissue
Infection
local factors to wound healing
circulation
microvascular and microvascular, sympathetic nervous system responses
Sensation
Decrease knowledge of pain, additional trauma to area
Mechanical stress
friction, shear, weight-bearing and pressure
Age and wound healing
slowed immune response.
decreased collagen synthesis
epidermal and dermal atrophy
less sweat and oil glands
decreased pain perception
decreased inflammatory response
Nutrition and wound healing
carbohydrates for energy
Protein for cellular repair and regeneration
comorbidities and wound healing
those affecting oxygen perfusion
-PVD, anemia , COPD, cardiac conditions
immunocompromised
-HIV, diabetes
Activity limitations
systemic factors
medication
behavioral risk taking
comorbidities
age
nutrition
Clinician induced factors for wound healing
inappropriate wound care
Prolonged or inappropriate use of antiseptics
Wrong dressing selection
Failure to detect or treat infection
Poor wound exploration
Poor temp management
Appropriate wound care
initial use of antiseptics to kill a broad spectrum of bacteria
maintenance care when wound healing is not priority
Use of iodine to encourage/maintain non-viable tissue desiccation
