Wound Healing I

Question 1

four phases of wound healing

Answer 1

inflammatory, debridement, proliferative, maturation

Question 2

inflammatory phase lasts _____ hours post-wound

Answer 2

0-6

Question 3

healing phase where there is a vascular and cellular response; immediate vasoconstriction followed by capillary dilation

Answer 3

inflammatory

Question 4

debridement phase lasts _____ hours post-wound

Answer 4

18-Jun

Question 5

healing phase where granulation tissue fills the wound and controls sepsis; shortened by surgical debridement, good hemostasis, adequate drainage

Answer 5

debridement

Question 6

proliferative phase lasts _____ hours post-wound

Answer 6

12+

Question 7

healing phase where there is collagen production, granulation tissue formation, wound contraction, and re-epithelialization

Answer 7

proliferative

Question 8

maturation phase occurs ______ post-wound

Answer 8

6d-2y

Question 9

healing phase characterized by wound contraction and collagen remodeling; increases strength by increasing number of intermolecular cross-links

Answer 9

maturation

Question 10

primary cells involved in the inflammatory phase of healing

Answer 10

platelets, leukocytes

Question 11

not essential to wound healing in the absence of hemorrhage

Answer 11

platelets

Question 12

role of platelets in healing

Answer 12

form blood clot, release chemoattractants and mitogens (stimulates mitosis/lymphocyte transformation)

Question 13

the chemoattractants released by platelets call _______ to the wound

Answer 13

monocytes, fibroblasts

Question 14

cells not required for wound healing, arrive on day 1 and begin to decline by day 2

Answer 14

neutrophils

Question 15

cells whose function is to clenase the wound of foreign particles and bacteria

Answer 15

neutrophils

Question 16

primary cells involved in proliferative phase of healing

Answer 16

monocytes, fibroblasts, epidermal, endothelial, t lymphs, mast

Question 17

cells attracted to the wound by factors released by platelets, leukocytes and other chemoattractants; become activated after adhering to the extracellular matrix

Answer 17

monocytes

Question 18

cells that are required for wound healing

Answer 18

macrophages

Question 19

activation of macrophages to release ______ is probably the most powerful stimulant to wound healing

Answer 19

growth factors

Question 20

cells involved in forming granulation tissue

Answer 20

macrophages, fibroblasts, endothelial cells

Question 21

benefits of granulation tissue in wound healing

Answer 21

surface for epithelial migration, resist infection, wound contraction, collagen production

Question 22

responsible for synthesis, deposition, and remodeling of the ECM; produce growth factors involved in replacing provisional ECM w/ collagenous matrix

Answer 22

fibroblasts

Question 23

exuberant granulation tissue typically only occurs ______, biopsy in other locations

Answer 23

distal to carpus/tarsus

Question 24

stops when the wound is filled w/ new granulation tissue

Answer 24

angiogenesis

Question 25

separation, duplication and migration of cells to cover wound

Answer 25

epithelialization

Question 26

granulation tissue to the height of the wound _______ is required for epithelialization to occur

Answer 26

basement membrane

Question 27

migrate under scab, release proteolytic enzymes to detach scab

Answer 27

epithelial cells

Question 28

epithelial cell migration distance in mm/day on lower limb? flank?

Question 29

inhibits epithelial cell migration; wound won’t heal until this is controlled

Answer 29

infection (also excess granulation tissue, repeat dressing changes, extreme hypothermia, desiccation of wound surface, reduced O2 tension affect healing)

Question 30

cells involved in remodeling

Answer 30

macrophages, fibroblasts, epidermal cells, endothelial cells

Question 31

wound contraction is d/t movement of ________

Answer 31

myofibroblasts

Question 32

collagen remodeling occurs after a 5-day lag; type ___ replaces type ____ collagen

Answer 32

I- III

Question 33

accumulation of collagen continues for about _____, after which time synthesis is balanced by degradation

Answer 33

3w

Question 34

objectives of treating traumatic wounds

Answer 34

preserve life, prevent infection

Question 35

goals of debridement

Answer 35

remove damaged tissue (etc.), obtain a fresh skin edge (for 1’ closure)

Question 36

light debridement, removal of gauze removes microdebris and exudate

Answer 36

wet-to-dry wrap

Question 37

w/ surgical debridement, there is liberal removal of ________

Answer 37

fascia, fat, muscle

Question 38

w/ surgical debridement, there is careful retention of _______

Answer 38

bone, tendons, nerves, vessels

Question 39

ideal fluids for lavage

Answer 39

saline, LRS (iodine or chlorhex ok)

Question 40

goals of wound closure are minimum _______

Answer 40

skin loss, tension, infection

Question 41

best option for wound closure, if possible

Answer 41

1’

Question 42

four types of wound closure

Answer 42

delayed primary, primary, secondary, none (2nd intention)

Question 43

wound closure that can be used up to 5 days post injury, used if infection is questionable and allows for initial inflammation and debridement to occur

Answer 43

delayed primary

Question 44

delayed primary or secondary closures are primarily used in ______ wounds in horses

Answer 44

lower leg, facial

Question 45

wound closure after the appearance of granulation tissue, approx 5-6 days post injury

Answer 45

secondary

Question 46

indications for second intention healing

Answer 46

infection, extensive tissue loss, excessive skin tension