Wound Healing Flashcards
What are the three phases of wound healing?
Inflammatory, proliferative, maturation
Inflammatory phase of healing
Injury to day 4 post injury.
Vasoconstriction –> fibrin blood clots –> vasodilation –> neutrophils, macrophages –> removal of bacteria and debris
Cardinal Signs of inflammation
Rubor et tumor cum calore et dolore (redness and swelling with warmth and pain)
Proliferative phase duration
Day 4-21 days post injury
Proliferative phase chain of events
Macrophages stimulate growth factors for:
endothelial cells –> new blood vessel growth*
fibroblasts –> collagen*
epithelial cells –> re-epithelialization
*leads to granulation tissue
What are growth factors?
Proteins that affect the proliferation, movement, maturation and
biosynthetic activity of cells.
Hypergranulation tissue
Too much oxygen can cause this. Too much granulation tissue, can make a mound and cause epibole, skin can’t grow over it.
Maturation phase duration
21 days to 2 years post injury
Maturation phase chain of events
collagen, deposition, remodeling, increase tensile strength, scar reduction.
Balance between scar forming and scar remodeling.
What happens if you have too much lysis in maturation phase/with remodeling?
Chronic wound
What happens if you have too much synthesis in maturation phase/with remodeling?
Keloid
3 R of immature scar
Red, raised, rigid
3 P’s of mature scar
Pale, planar, pliable
Keloid Scarring
Too much synthesis and not enough lysis. Keloid scarring extend BEYOND the boundaries of the original injury which is what differentiates it from hypertrophic scarring. More likely in people with more pigmentation.
Epithelialization
RE-epithelialization occurs from migrating epithelial cells, may migrate from the side, from viable epithlial cells lining epidermal appendages (hair follicles). Without remaining epidermal appendages, will need skin graft..
Skin buds
Translucent pale pink epithelial cells, very fragile
Angiogenesis
Endothelial cells are stimulated by hypoxia, sprout from existing vessels forming a capillary bud, bud form capillary loops, loops anastamose forming vascular system, VERY FRAGILE.
Process starts as early as 20 minutes post injury, at the end of the inflammatory phase the angiogenses to the immediate area should be complete.
Latex allergy predispositions
frequent exposure, occupational hazards, multiple surgeries, spina bifida (myelomeningocele)
What is sebum?
Skins natural moisturizer, comes off when you wash your hands with harsh detergents
What’s Xeroderma/Xerosis
Very, Very, Very dry skin
What does skin cancer look like?
Asymmetrical border, color changes, diameter changes. Prevention is best strategy.
