Wound Healing Physiology (Normal) Flashcards
Superficial Wound Healing
What 2 wound types are included in superficial skin alterations?
What else can superficial skin alterations be an indication of?
What is Erupting Volcano Effect?
How do superficial wounds typically heal?
Stage 1 pressure ulcers.
1st degree sunburns and contusions. (Skin is not broken)
Superficial skin involvement can indicate deeper soft tissue trauma.
(If deeper tissue involvement is suspected look for changes in skin color, temperature, swelling and sensation.)
volcano–deeper tissue damage manifested under the sin as a purple discoloration leading to “purple ulcers”.
Most superficial wound heal by epithelialization over time.
Partial-Thickness Wound healing
What is it?
What is epithelialization?
What makes this healing process occur faster?
What are 4 examples of partial-thickness wounds?
Partial loss of the dermis and heals mainly through epithelialization.
Epi…resurfacing of a wound by new epithelial cells which are mostly keratinocytes.
Dermal appendages–islands of epidermis can appear throughout the wound surface and speed the resurfacing process.
Skin tears…(old people)
Abrasions
2nd degree burns
Stage II pressure ulcers (Skin is broken)
Primary healing intention…
What medical function is this most closely related to?
What are the 2 main activities of cells during healing?
What 2 things don’t happen?
Associated with surgical wound healing.
Main activity is connective tissue deposition and epithelialization.
No granulation tissue formation
No wound contraction (myofibrils don’t have to work to pull the edges together.)
Full-Thickness or secondary intention wound healing is most effective when?
How does the wound close?
What are the 4 overlapping phases of healing?
Why might a skin graft be used?
Most effective when wound extends through ALL LAYERS of the skin &/or underlying tissue.
Closes through Contracture and scar formation
- Inflammation
- Epithelialization
- Proliferation
- Remodeling
Skin graft–if contractures will occur and cause functional damage.
Chronic Wound Healing
What is the best method to heal this type of wound?
What is the definition of a chronic wound?
Define orderly
Define timely
secondary intention.
Wounds that DO NOT PROGRESS THROUGH THE STAGES of healing in an ORDERLY and TIMELY MANNER are considered chronic.
orderly–progressing through the biological sequences of wound healing.
Timely–progression of the phases of repair to expeditiously heal the wound.
What is Healing Cascade?
What does this indicate for wound care?
Do all wounds heal at the same pace?
Series of predictable events or phases of healing
All acute wounds should progress through the same biological repair process.
No. superficial is fastest and full-thickness is slow.
What is Inflammation?
How long does it typically last?
1st phase of healing and begins shortly after injury, triggering the remaining phases of wound healing.
lasts 3-7 days
What are the signs and symptoms of inflammation? 5
Color in surrounding skin. Warm skin. Turgor (swelling) Pain (change in sensation) Reduced function--not always true
Name 3 major goals of the inflammatory phase
What are growth factors?
Hemostasis (controlled bleeding)
BREAKDOWN and REMOVAL of cellular, extracellular, and pathogenic debris. (…this can result in …)
A clean wound site for tissue restoration and initiation of the repair process.
signalling biochemical substances that are expressed when an injury occurs.
Coagulation Cascade or Hemostasis
What is Hemostasis?
When does it occur?
What is the 1st (primary) major function of platelets?
What platelet activation cause?
Fibrin clot (made by platelets) serves as the foundation for what? and the pathway for what?
controlled bleeding.–clotting and vasoconstriction lasting 5 - 10 minutes after skin incision to control hemorrhaging and reduce blood loss.
Immediately after injury
Hemostasis.
Activation causes changes in platelet structure to allow clot formation.
Foundation for collagen deposit and pathway for the influx of leukocytes and fibroblasts to the wound site.
What is the second function of platelets?
Produce and release growth factors and cytokines
Growth factors facilitate and control what?
They do this by perform these 3 functions?
What phase do growth factors initiate?
Facilitate and control tissue deposition.
1 Cell growth–mitogenesis
- Cell migration–Chemoattractants
- Perform regulatory functions.
Help start proliferation.
What do Cytokines do?
There are two types of cytokines. Name them.
Cytokines: communicate with and attract immune system cells to the area of injury to begin inflammatory response and eat foreign organisms and debris.
2 groups–Proinflammatory: stimulatory actions on inflammatory cells
Anti-inflammatory: powerful inhibitory action on inflammatory cells.
What is the 6 step vascular response to inflammation?
- Injured blood vessels leak transudate (clear fluid) to cause edema. Loss of vessel pressure and increase of interstitial pressure stop loss of blood.
- Blood vessels constrict.
- Platelets collect at injury to form a plug and isolate injury.
- Platelets produce growth factors and chemotactic agents (cytokines)…growth factors grow cells and chemos attract cells for wound repair.
- 30 min later vessel vasodilate and push fluid into interstitial space…yellow/tan viscous fluid called exudate.
- Histamines from mast cells cause vasodilation. Prostaglandins released by injured cells produce a long lasting effect.
What is the 4.5 step cellular response to inflammation?
- Neutrophils from cartilage and blood vessels.
- Margination–(neutrophils bind to vessel walls)
- 5 Diapedesis–neutrophils use psuedopid to leave vessel and move toward injury.
- Diapedesis.
- Chemotaxis
