Wound Healing/Burn

Question 1

3 phases of wound healing are?

Answer 1

Inflammation

Proliferation

Maturation

Question 2

First cells that appear at a wound?

Answer 2

Neutrophils—-> followed by macrophages

Question 3

Proliferation phase of wound healing is characterized by what?

Answer 3

Granulation tissue—> capillary bed with fibroblasts, macrophages, loose arrangement of collagen, fibronectin, hyualorunonic acid

Question 4

Principal collagen found in skin and bone?

Answer 4

Type I—-> MOST COMMON collagen

Question 5

What collagen seen in early wound healing compared to late?

Answer 5

Early—-> Type III

Later—-> Type I

Question 6

Keloid v hypertrophic scars?

Answer 6

Keloids grow outside the borders of a wound and rarely regress with time

Hypertrophic scars are raised scars within the confines of the original wound; regress with time

Question 7

What kinds of collagens do we see in keloids v hypertrophic scars?

Answer 7

Hypertrophic scars; well-organized type III collagen

Keloids: disorganized type I and III collagen

Question 8

Squamous cell carcinoma from a chronic burn wound?

Answer 8

Marjolin ulcer

Question 9

MCC of wound healing delay?

Answer 9

Wound infection

Bacterial counts >10^5 would prevent wound healing by any means

Question 10

Stages of wound healing:

Answer 10

Question 11

How does nicotine affect wound healing?

Answer 11

Vasoconstrictor

Impairs O2 delivery, increases platelet adhesions, decreases RBCs proliferation

Question 12

What’s unique with fetal wound healing?

Answer 12

No scar formation

Immaturity of fetal immune system may explain lack of scar formation during wound repair

Question 13

Macrophages involved in the inflammatory phase of wound healing release what interleukins?

Answer 13

1
6
8
TNF-a

Question 14

Wound maximum tensile strength achieved by?

Answer 14

8 weeks; at 8 weeks a wound has reached its 100% tensile strength, which is 80% of its pre-wound strength

At 6 weeks, tensile strength of a wound is 60%

Question 15

What do leukotrienes do during the inflammatory response?

Answer 15

Mediate release of platelet aggragating factor

Increase cap permeability

Produced from arachidonic acid

Stimulate bronchoconstriction

Question 16

Collagen is made up of?

Answer 16

Hydroxyproline and hydroxylysine

The peptides are cross linked by Vit C

Question 17

Type III collagen found where?

Answer 17

Blood vessels
Uterus
Fetal skin

Question 18

Type IV and V collagen found where?

Answer 18

IV—- basement membrane

V— cornea

Question 19

Principal collagen of skin./bone?

Answer 19

Type I

Question 20

4 classes of operative wounds;

Answer 20

Question 21

When does collagen synthesis peak during wound healing?

Answer 21

3rd week- 21 days

Question 22

What effect does nicotine have on wound healing?

Answer 22

Causes vasoconstriction
Increases platelet aggregation
Limits oxygen delivery
Impairs proliferation of RBCs, fibroblasts and macrophages

Question 23

How many weeks out is a wounds tensile strength at its max?

Answer 23

At 8 weeks

80% of its pre-wound strength

Question 24

What’s the tensile strength of a wound at 6 weeks?

Answer 24

60%

Question 25

Curreri formula for burns?

Answer 25

25 kcal x weight in kg + 40 kcal x TBSA

Question 26

Daily Na requirements of a normal human?

Answer 26

2 meQ/kg

Question 27

Daily K requirements for a human?

Answer 27

1 meQ/kg

Question 28

Daily water requirements of a normal human?

Answer 28

30 ml/kg

Question 29

Daily Carolina requirements for a human?

Answer 29

25 kcal/kg

If a burn patient; 35 kcal/kg

Question 30

Anion gap?

Answer 30

Na - (Cl + HCO3)

Normal 8-12