Wound Healing and Management of Chronic Wounds Flashcards
Platelets play are the chief effector cells during hemostasis
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Platelet release several growth factors and cytokines, such
as platelet-derived growth factor (PDGF) and transforming growth
factor-P (TGF-P)
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Microphage are also responsible
for releasing several proangiogenic and antiangiogenic growth factors that are critical for revascularization of wounds
F Platelets are also responsible
for releasing several proangiogenic and antiangiogenic growth factors that are critical for revascularization of wounds
the inflammatory phase lasts 48 hours
T
macrophage invasion is critical to
the inflammatory phase because macrophage-defective or macrophage-depleted animals undergo .abnormal wound healing.
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Macrophages are responsible
for releasing a whole host of mediators primarily through binding
to integrin receptors on the ECM
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tumor necrosis factor a
and interleukin-I (IL-1)4 secreted from the microphage
t
Proliferation phase 48 hours to 10 days after tissue injury
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Epidermal growth factors, heparin-binding epidermal growth factor (HB-EGF), and transforming growth factor-alpha (TGF-a), which are the main
members of the epidermal growth factor family involved in wound
healing
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Fibroblasts and macrophages
replace the fibrin mesh to form granulation tissue
T
Remodeling start from2 weeks and can last for years
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type I collagen into mainly type III collagen by matrix metalloproteinases (MMPs)
F type III collagen into mainly type I collagen by matrix metalloproteinases (MMPs)
Cutaneous scar tissue is composed of high ECM macromolecules compare to normal tissue
F Cutaneous scar tissue is composed of the same ECM macromolecules as normal tissue
Increased
levels of TGF-Pl have been implicated in hypertrophic adult scars
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Fibroblasts are thought to generate cell traction
forces that are much greater than needed for cell migration
T
cells without mechanical stress or stimuli
adopt a spherical shape and enter cell-cycle arrest and apoptosis
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Chronic wound any wound that last more than 1 month
F that persist for longer than 6 weeks.
Percentage of venous & arterial ulcer
venous insufficiency constitute
70%, arterial disease 10%, and ulcers of mixed etiology 15% of leg
ulcer presentations
fibrin is known to decrease collagen production
T
Venous ulcer over bony prominences
F Arterail
The prevalence of diabetic foot ulcers in individuals with diabetes
15%
Topical antimicrobials have promoted bacterial resistance
T
NPWT with instillation and adjunctive sodium hypochlorite solution
was effective at reducing both planktonic and nonplanktonic (biofilm) microorganisms
T
no significant difference
in the percentage of ulcers healed when compared with placebo or
platelet-poor plasma therapy
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What is Apligraf?
Bovine collagen matrix incorporated with
human neonatal fibroblasts and neonatal keratinocytes to act as a
scaffold as well as providing cells that produce growth factors and
ECM components
Dermagraft comprises a polyglactin scaffold with dermal neonatal fibroblasts.
T
Epicel
cultured epithelial autografts using patients’ own keratinocytes,
what is Integra ?
Integra™ (Integra LifeSciences) is a bilayer
matrix of bovine collagen and glycosaminoglycan derived from shark
skin that is lyophilized to form a highly porous scaffold
Allopatch
which is a decellularized scaffold derived from human cadaveric
tissue, has demonstrated efficacy in closure of nonhealing diabetic
foot ulcers
Grafix
Is a cryopreserved placental membrane, have shown to significantly improve diabetic foot ulcer healing and reduce related complications
fetal wound healing during the first two trimesters differs from the normal wound healing process
T Scarless healing
After 48 hours the macrophage becomes the dominant cell type. In contrast
to neutrophil, this is critical to wound healing because it orchestrates growth factors such as TGF-beta, which
promotes collagen production
T
During remodeling phase, net
collagen production is static
T
PDGF promotes fibroblast,
endothelial cell, and smooth muscle proliferation rather than keratinocyte proliferation
T
Hypertrophic scars have
an equal sex ratio, are typically seen in younger age groups
T
Keloid scars are only seen in humans
T
east harmful for imaging of the limp vascular diseas is CTA
F Magnetic resonance angiography (MRA)
A normal anklebrachial pressure index is between 0.9 and 1.2 greater than 1.2 suggests calcification A value of less than 0.5
suggests critical arterial stenosis
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Osteoradionecrosis (ORN) is a condition where bone death occurs secondary to radiation and is most commonly
seen in the mandible following treatment of head and neck cancers best trerated with HPO
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Apligraf
comprises a bilayer of bovine collagen
and human foreskin-derived fibroblast matrix under human foreskin-derived keratinocytes use in diabetic foot and
venous leg ulcers
The hypoxic environment increases expression of hypoxia-inducible
factor 1 (HIF-la) protein to serve as the primary stimulus of angiogenesis
T
Granulation tissue, also known as new stroma, consists of new connective tissue
(specifically hyaluronic acid, procollagen, elastin, and proteoglycan)
and blood vessels
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Fibroblasts are also injured and
contribute to the late effects of radiation injury such as fibrosis and
contraction
T
Systemic antibiotics are beneficial in infected chronic wounds but
are not indicated for most chronic wounds that are merely colonized
with bacteria
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obesity is related to lower levels of lymphocyte proliferate, altered cytokine levels and peripheral immune function which improves upon weight loss
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