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Integumentary 1 - Midterm > Wound Healing - Class 5 > Flashcards

Wound Healing - Class 5 Flashcards

1
Q

epidermal healing response

A

begins w/in 24-48 hours

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2
Q

what do the epithelial cells do –> epidermal healing

A

detach from the basal layer

migrate across the wound

proliferate by mitosis

differentiate into mature epidermal cells

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3
Q

contact guidance –> epidermal healing

A

when epithelial cells contact each epithelial cells

they change direction

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4
Q

contract inhibition –> epidermal healing

A

when the epithelial cells are contact on all sides by other epithelial cells

they stop migration

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5
Q

dermal healing has

A

3 phases

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6
Q

3 phases of dermal healing

A

inflammatory

fibroblastic

maturation

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7
Q

fibroblastic phase includes

A

collagen synthesis

wound contraction

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8
Q

collagen synthesis

A

amino acids link together to form polypeptide chains

amino acids are hydroxylated and the chain is called protocollagen

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9
Q

protocollagen

A

3 protocollagen chains are twisted together to form a helix called tropocollagen

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10
Q

tropocollagen

A

multiple tropocollagen units form collagen filaments

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11
Q

collagen filaments

A

bundles of filaments make a fibril

fibrils form a fiber

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12
Q

wound contraction

A

active process d/t fibroblasts/myofibrils

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13
Q

what do the fibroblasts and myofibrils do –> wound contraction

A

attempt to close a wound in which a loss of tissue has occurred

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14
Q

amount of contraction is dependent on –> wound contraction

A

amount of available mobile skin around the defect

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15
Q

what would cause wound contraction to stop

A

edges meet

tension in the surrounding skin equals or exceeds the force of contraction

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16
Q

what may decrease contraction

A

skin grafts

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17
Q

scaring

A

ration of collagen breakdown to production determines the type of scar that forms

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18
Q

if rate of breakdown exceeds production

A

scar becomes softer and less bulky

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19
Q

if rate of production exceeds breakdown

A

then a hypertrophic scar may result

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20
Q

hypertrophic scar

A

enlarged red

raised

rigid scar

stays w/in the boundary of the original wound

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21
Q

keloid scar

A

large

firm scar

extends beyond the boundaries of the initial wound

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22
Q

factors which may impede wound healing

A

age

body structure

stress

nutrition

drugs

smoking

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23
Q

age

A

< 2

> 65

less nutritional stores

inadequate immune system

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24
Q

body structure

A

obese

emaciated

25
Q

obese

A

blood supply to tissue

decreased cell proliferation

26
Q

emaciated

A

decrease energy stores

decreased time metabolism

27
Q

stress

A

inhibits cell proliferation

28
Q

nutrition

A

need vitamin C

zinc

iron for collagen formation

29
Q

drugs

A

steroids

ASA

decrease inflammation and epithelialization

30
Q

smoking

A

decreases oxygenation to tissue

vasoconstriction

31
Q

types of wound healing

A

primary intention

secondary intention

tertiary intention

32
Q

skin grafting is

A

surgical procedure w/ dermatome

33
Q

skin grafts can be

A

allograft

xenograft

34
Q

allograft

A

homograft

same species

cadaver

35
Q

xenograft

A

heterograft

another species

porcine

36
Q

where is an artificial skin graft used

A

where large areas of burn exist

coverage is done for survival

37
Q

split thickness skin graft (STSG)

A

consists of epidermis and portion of underlying dermis

38
Q

types of artificial skin grafts

A

meshed

sheet

39
Q

meshed skin graft

A

expands the donor skin to provide more coverage of burn wound w/ less skin

40
Q

what does a meshed skin graft leave

A

waffle appearance

will not go away

41
Q

when is a meshed skin graft better

A

infected wounds

wounds w/ irregular contours

42
Q

sheet skin graft is better for

A

more cosmetic

43
Q

sheet skin grafts are

A

more durable

contraction is limited

44
Q

STSG –> sheet

A

may contract more while healing more than FTSG

45
Q

FTSG leave a –> sheet

A

full thickness lesion

46
Q

what contract less –> sheet

A

non-meshed

47
Q

PTs shouldnt –> grafts

A

move a grafted area for 5 days

during txs keep elevated

48
Q

LE grafts

A

can move after 5 days

should hold off ambulation for approximately 5-6 days
–> depending on how the grafts look

49
Q

dermal implants

A

integra

50
Q

inhalation injuries

A

increase severity of the injury

51
Q

types of inhalation injuries

A

thermal

chemical

CO poisoning

52
Q

dx of inhalation injuries

A

facial burns

singed nasal hairs

tinged sputum

closed space injury

blood work

bronchoscopy findings

hoarseness

53
Q

pathophys of inhalation injuries

A

inflammation can cause mechanical obstruction

necrosis of damaged epithelium, mucosal sloughs

bronchopneumonia is likely in severe cases

decreased pliability of the lungs, aspect of restrictive device

54
Q

rehab considerations –> inhalation injuries

A

airway should be secure

pt should have good O2 sats

monitor for respiratory distress

promote mobilization of secretions

55
Q

nutrition

A

requirements are high for the burn pt

additional energy is required to promote wound healing

56
Q

if the body’s caloric intakes are not met

A

body may resort to muscle breakdown

57
Q

if pt doesnt meet their caloric requirements

A

NG tube

58
Q

what may the pt require –> calories

A

4000-5000 per day

children require even greater amount of calories per day

Integumentary 1 - Midterm (23 decks)

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