Wounding Healing II Flashcards
What is the healing of skin wounds based on
naturae and size of the wound
1st intention healing
closed, noninfected wound the margins are apposed and healing occurs directly with minimum granulation tissue
what predominates in healing by 1st intention
epithelial regeneration over fibrosis
2nd intention healing
edges are not lined up (large, gaping wounds) more granulation, more epitheliazation, more fibrosis
wound contraction
wound healed by 2nd intention, has action of myofibroblasts in granulatio ntissue
contracture
exaggeration of contraction
results in severe deformity of wound and surrounding tissues
common in burn victims
What does contracture result in
limited joint mobility, prevents full extension of affected part
myofibroblasts
found in granulation tissue
have hybrid properties of fibroblasts and smooth muscle cells
what do myofibiroblasts product
colalgens and other ECM proteins, but can also contract
keloids
accumulation of lots of collagen
more common in blacks
exuberant granulation tissue (proud flesh)
abnormal cell growth and ECM production in wound healing
protrudes above the level of surrounding skin wound, prevent wound closure
how do you treat proud flesh
surgery
what do keloids look like histologically
dermis replaced by a meshwork of thick collagen fibers, lack glands and hair follicles
hypotrophic scars
sunken, hyperpigmented appearance due to loss of collagen and ground substance (stretch marks)
hypertrophic scar
similar to keloid, but never gets worse beyond 6 months, also you can remove surgically and it won’t come back
