Wounds and Wound Healing

Question 1

What are some causes of wounds?

Answer 1

Traumatic, surgical, chemical, thermal

Question 2

What are some wound types?

Answer 2

Graze/abrasion/erosion
Bruising
Hematoma
Contusion
Laceration
Puncture wounds (potentially more serious than they appear as could affect deeper structures).

Question 3

Define a HEMATOMA

Answer 3

A hematoma is a solid swelling of clotted blood within the tissues

Question 4

Define a CONTUSION

Answer 4

A contusion is a region of injured tissue where the blood capillaries have been damaged or ruptured; a bruise.

Question 5

Define a LACERATION

Answer 5

A laceration is a deep cut or tear in skin.

Question 6

What are the phases of wound healing?

Answer 6

Inflammatory, granulation tissue, maturation, contraction

Question 7

Describe the inflammatory phase

Answer 7

First stage of wound healing - fibrocellular clot is formed by platelets when the cut is sustained. Boundary between living and dead tissue is identified and necrotic tissue, debris, infection are removed (maybe be natural or surgical).

Question 8

Describe granulation tissue

Answer 8

The second stage of wound healing - new conncective tissue is formed, typically grows from the base of the wound; able to fill wounds of almost any size. Increasing number of fibroblasts to provide structure.

Question 9

Describe the maturation phase

Answer 9

Third stage of wound healing - epithelial cells migrate across the new tissue to form a barrier between the wound and the environment in a process called epithelialization.
In limbs this occurs at a rate of 1-1.5mm/10 days
It can proceed 1-3 hours post injury but requires granulation tissue to be viable.
Moist environment is optimal

Question 10

Describe the contraction phase

Answer 10

Final stage of wound healing - occurs 5-15 days post wound. Can last for several weeks and continue after the wound is fully re-epithialized. Can occur at a speed of 0.75mm/day depending on the size and the amount of loose tissue.

Question 11

What are some factors that enhance wound healing?

Answer 11

• early intervention
• elimination and prevention of contamination (bandaging, washing out the body cavity)
• sound surgical principles (appropriate cleaning of wound)
• specialised dressings (moist wound management)
• immobility

Question 12

What are some factors that inhibit wound healing?

Answer 12

• infection
• site of the wound e.g. distal wounds heal much less effectively; area of high activity e.g. hock
• movement
• foreign body in the wound
• necrotic tissue
• poor blood/oxygen supply
• poor nutritional and health status

Question 13

What is proud flesh?

Answer 13

Excessive growth of granulation tissue and blood vessels required for a wound to heal.

Question 14

How can the formation of proud flesh be reduced?

Answer 14

• careful management of early stages of a wound
• control of infection
• removal of foreign bodies
• restriction of wound movement
  May require surgical removal, corticosteroid cream or traditionally copper sulphate or silver nitrate (although now not recommended).