Wound Healing Flashcards
What is the body’s largest organ?
Integumentary system (Skin)
What layers make up the integumentary system?
Epidermis
Dermis
Subcutaneous fatty tissue
What is the most superficial layer of skin?
Epidermis
What layer of skin is considered the true skin?
Dermis
Distinguish which layers of skin are vascular versus avascular.
Epidermis = avascular Dermis = vascular
What are the five key functions of the integumentary system?
Protection Sensation Thermoregulation Excretion of sweat Vitamin D synthesis
What are the 3 phases of wound healing?
Phase 1: Inflammatory
Phase 2: Proliferative
Phase 3: Maturation
How long does the inflammatory phase last?
1-10 days
How long does the proliferative phase last?
3-21 days
How long does the maturation phase last?
7 days to 2 years
What is the immune system’s initial response to a wound?
Inflammation
How does the body rapidly establish homeostasis in the presence of a wound? What phase does this occur in?
Through platelet activation and the clotting cascade
Occurs in the INFLAMMATORY phase
What 4 things occur in the inflammatory phase of wound healing?
- Re-establish homeostasis via platelet and clotting cascade activation
- Removal of debris and necrosis
- Bacteria killed by mast cells, neutrophils and leukocytes
- Re-epithelization
What is the main goal of the inflammatory phase of healing?
Establish a clean wound bed which signals tissue restoration and the start of permanent wound healing
When does re-epithelization typically begin?
Within 24 hours
What signals the beginning of the proliferation phase?
Formation of new tissue
What is restored during the proliferative phase?
Skin integrity
What 3 things occur in the proliferative phase of wound healing?
- Capillary buds and granulation tissue fill the wound bed
- Collagen matrix is formed
- Epithelization and wound contraction
What 2 processes give rise to wound closure?
Epithelization
Wound contraction
When is the maturation phase initiated?
When granulation tissue and epithelial differentiation appear in the wound bed
What 2 things occur in the maturation phase of wound healing?
- Fiber reorganization and contraction shrink the scar
2. Collagen lysis and synthesis strengthen the scar tissue
What 2 processes shrink the scar tissue?
Fiber reorganization and contraction
What 2 processes strengthen the scar tissue?
Collagen lysis and synthesis
What are characteristics of an immature scar?
Red
Raised
Rigid
What are characteristics of a mature scar?
Pale
Flat
Pliable
Newly repaired tissues have approximately ____ % of pre-injury tensile integrity and should be protected to prevent re-injury.
15%
Over time tensile integrity may increase to up to ___ % of pre-injury strength.
80%
What condition can significantly impact the maturation phase of healing?
Hypertrophic scarring
What type of wounds are typically treated with healing by primary intention?
Acute wounds with minimal tissue loss
What is healing by primary intention?
Closing the edge of a wound with sutures, staples or adhesives to facilitate re-epithelization
Provide 4 examples of wounds that heal via primary intention.
Surgical incision
Laceration
Puncture
Superficial and partial thickness wounds
What type of healing is used to treat a puncture or laceration wound?
Primary intention
What is healing by secondary intention?
Permitting the wound to close on its own without superficial closure
List 4 characteristics of wounds that heal via secondary intention.
- Significant tissue loss
- Necrosis
- Irregular wound margins
- Infection or debris contamination
Wounds that heal via secondary intention require ____ and have significantly larger _____ than wounds that heal via primary intention.
Require ongoing wound care
Larger scars
What wounds typically heal via secondary intention?
Pressure Ulcers
Full Thickness wounds
What is an alternative name for healing by tertiary intention?
Delayed primary intention healing
What is healing by tertiary intention?
Wounds at risk for developing complications are left open until risk factors are dealt with, and then the wound is close via primary intention.
What kinds of wounds may be treated with tertiary intention?
Contaminated wounds
Infected wounds
Sepsis
What are 8 factors that influence wound healing?
- Age
- Co-morbidities
- Edema
- Harsh/Inappropriate wound care
- Infection
- Lifestyle
- Medication
- Obesity
What is the difference between contamination, colonization and infection?
Contamination = nonreplicating bacteria on wound surface that do not cause further damage; do no stimulate inflammatory process
Colonization = replicating bacteria on wound surface that do not cause further damage; do no stimulate inflammatory process
Infection: replicating bacteria viable beyond the wound surface that causes further damage; stimulates the inflammatory process
