Wound Healing

Question 1

What are the three layers of skin?

Answer 1

Epidermis - dead
Dermis - Alive
Hypodermis - protection layer

Question 2

What are the two phases of wound healing?

Answer 2

Haemostasis - clotting

Tissue repair

Question 3

Describe the haemostasis phase of wound healing

Answer 3

1) blood coagulation cascade - exposure of blood to extra vascular tissue activates platelets and they form a plug
2) Platelet plug strengthened by fibrin
3) Fibrinous clot acts as a mix for migration of inflammatory and tissue repair cells into the wound

Question 4

Describe the inflammation (tissue repair) phase of wound healing

Answer 4

1) 0-4 days
2) Early phase (haemostasis): vasoconstriction, vasodilation, coagulation.
3) Late phase: recruitment and activity of inflammatory cells.
4) A vascular and cellular response
5) Local capillaries become more permeable and inflammatory exudate infiltrates surrounding tissues

Question 5

Describe the Reconstruction (tissue repair) phase of wound healing

Answer 5

1) 2-24 days
2) Angiogenesis - new blood vessel growth
3) Granulation - new skin (red)
4) Contraction - Wound edges contract together
5) Epitheliasation - Pale pink skin

Question 6

Describe the maturation (tissue repair) phase of wound healing

Answer 6

1) 24-365 days

2) Scar tissue remodeled and strengthened by synthesis of collagen and elastin

Question 7

What are examples of aberrant wound healing?

Answer 7

Hypergranulation
Contracture
Hypertrophic scar
Keloid

Question 8

Describe an acute wound

Answer 8

1) a wound that heals by primary intention
2) a traumatic or surgical wound which heals by secondary intention
3) Proceeds through an orderly and timely reparation process that results in sustained restoration of anatomical integrity

Question 9

Describe a chronic wound

Answer 9

1) Reparative process does not proceed through an orderly and timely process
2) complicated and delayed by intrinsic and extrinsic factors that impact on THE PERSON, THEIR ENVIRONMENT & THE WOUND

Question 10

What are the biochemical characteristics of a healing wound?

Answer 10

• Decreased pro-inflammatory cytokine
• decreased matrix metaloproteinases
• increased growth factor
• cells capable of rapid response
• increased cell mitosis

Question 11

What are the biochemical characteristics of a chronic wound?

Answer 11

• increased pro inflammatory cytokins
• increased matrix metaloproteinases
• varied levels of growth factors
• senescent cells
• decreased mitogenic activity

Question 12

What are systemic signs of infection

Answer 12

• Elevated temperature
• Tachycardia
• Rigor
• Malaise
• Elevated leukocytes

Question 13

Define critical colonisation

Answer 13

• Increased bacterial burden
• Bacterial Imbalance
• Covert infection
• Local injection
• Topical infection

Question 14

What are two reactions to threats

Answer 14

1) Adaption - develop resistance

2) Self-protection - forms biofilm

Question 15

Define Inherent bacterial resistance

Answer 15

Bacteria is naturally resistant to the antimicrobial agent

Question 16

Define Acquired bacterial resistance

Answer 16

Bacteria develops resistance through bacterial genome, through vertical evolution (a mutation of the organism) or horizontal evolution (genetic transfer of resistant genes from one bacterium to another.