Wound healing Flashcards
Briefly describe the physiology of blood clotting.
Read page 27-28 on document (old written doc)
Anson: what kind of question is this.. Doesn’t specify marks either
What are the medical causes for prolonged wound healing?
Diabetes mellitus, keloids, fibrosis, hereditary healing disorders, jaundice, uremia
State two investigations that can be taken for DM and hereditary bleeding disorder
- Glucometer for DM (Ken: HbA1c?)
* PTT, PT, platelet test, TT (hereditary bleeding disorder)
List 4 factors that affect wound healing (2)
Oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition
What is acute inflammation? List the clinical signs for acute inflammation (2.5)
short-term process occurring in response to tissue injury, usually appearing within minutes or hours
Ken:
A localized protective response elicited by injury or destruction of tissues, which serves to destroy, dilute, or wall off both the injurious agent and the injured tissue
5 signs: pain, redness, swelling, heat, loss of function
Functional process of the neutrophils during bacterial infection (2.5)
Activated tissues at the site of inflammation release cytokines
These cytokines attract neutrophils to move to area of infection, via a chemotactic gradient. They move by chemotaxis
Phagocytosis – engulf bacteria and kill them
Degranulation – release cytokines and other signals to signal other cells and inflammation and kill bacteria.
Name the cells involved in soft tissue wound healing & their respective functions (2)
White blood cells – inflammatory response, recruit other cells, prevent infection
Mast cells – inflammatory response, prevent infection
Fibroblasts – granulation tissue formation
What is the major difference between healing by repair & regeneration (2 or 3)
Repair: unspecific form of healing in which the wound heals by fibrosis and scar formation.
Regeneration: specific substitution of the tissue, i.e. the superficial epidermis, mucosa or fetal skin
Ken:
Repair: it is healing by proliferation of CT elements resulting in fibrosis and scarring
Regeneration: It is healing by proliferation of parenchymal cells, results in complete restoration of the original tissue
What are the histological appearance of the gingival tissue after scaling and root planing? (3)
- Partial removal of sulcal epithelium
- Tearing and splitting of rete pegs
- Occasionally, underlying connective tissue may be injured
- (All heals within 1 week + destruction depends on severity of inflammation)
Describe the healing of the extraction socket immediately after operation until it is fully healed (5)
Immediately (Socket filled with blood and blood clot formation occurs)
0-1 week (Almost all blood clot remodeled and replaced by granulation tissue)
After 1st week (Deposition of mineralized tissue begins)
2-4 weeks (No more blood clots + Erythrocytes scattered between mensenchymal cells + Granulation tissue and provisional matrix are 30-50% of total tissue filling the socket)
6-8 weeks (Most of GT is replaced with provisional matrix (60%) and woven bone (35%) + Margin of socket of has immature woven bone)
12-24 weeks (Provisional matrix and woven bone (lamellar bone may still not fully form yet!) + should see some lamellar bone
What are blood clot, granulation tissue, provisional matrix, woven bone and lamellar bone and marrow?
• blood clot (BC), consisting of erythrocytes and leukocytes embedded in a fibrin network;
What is granulation tissue?
• granulation tissue (GT), rich in newly formed vascular structures, inflammatory cells and erythrocytes;
What is provisional matrix?
• provisional matrix (PM), presenting densely packed mesenchymal cells, collagen fibers and vessels but no or only scattered inflammatory cells;
What is woven bone?
• woven bone (WB), consisting of fingerlike projections of immature bone embedded in a primary spongiosa;
What is lamellar bone and marrow?
• lamellar bone and marrow (LB/BM), i.e. lamellae of mature, mineralized bone harboring secondary osteons surrounded by marrow spaces rich in vessels, adipocytes, mesenchymal cells and inflammatory cells.