Wound Healing

  1. What is a wound?
    any physical disruption of tissue continuity
  2. What are the different phases of wound healing?
    • inflammatory phase
    • debridement phase
    • repair phase
    • maturation phase
  3. What is the first thing that happens during the inflammatory phase?
    vasoconstriction slows hemorrhage rate
  4. What occurs within 5 - 10 minutes in the inflammatory phase?
  5. What does vasodilation do during the inflammatory phase?
    lets plasma proteins, clotting factors, and WBCs into the wound
  6. What happens after vasodilation during the inflammatory phase?
    blood clot forms within wound
  7. What happens after the blood clot forms during the inflammatory phase of wound healing?
    scab forms from dried clot
  8. What is the purpose of a scab?
    to protect the healing surface of the wound
  9. When does the debridement phase begin?
    6 hours after the injury
  10. What happes during the debridement phase?
    • WBCs enter wound (segs and monocytes)
    • phagocytizes debris - dead tissue and microbes
  11. What forms at the end of the debridement phase?
    exudate is formed - WBCs + fluid that has seeped from the wound
  12. When is the repair phase of the wound healing process?
    3 - 5 days
  13. What cell types are involved in the repair phase?
    • fibroblasts
    • endothelial cells
    • epithelial cells
  14. What happens during the maturation phase of wound healing?
    • collagen organizes along lines of stress
    • remodels and shrinks over time
    • scar forms
  15. How long does it take for a a minor wound to form a scar?
    10 days
  16. When does a scar gain maximum strength?
    months to years
  17. Does a scar regain ull normal strength of regular skin?
  18. What do fibroblasts look like?
    spindle shaped cells
  19. What do fibroblasts do?
    • divide to fill space
    • make collagen
  20. When do fibroblasts disappear?
    in a month or so
  21. What are fibroblasts?
    white stands of protein
  22. What are endothelial cells?
    cell that line the blood vessels
  23. What do endothelial cells do?
    divide to form new blood vessels - bridge the wound
  24. What is granulation tissue composed of?
    fibroblasts and endothelial cells
  25. What are epithelial cells?
    skin cells
  26. Where do epithelial cells divide in a wound?
    at the edge of a wound
  27. What are sutured incisions quickly covered by?
    epithelial cells
  28. Why do larger wounds take longer for epithelial cells to cover it?
    granulation bed needs to fill in the "hole" first because epithelial cells need a surface to migrate across
  29. Does new skin make new hair follicles?
    no - new skin is hairless
  30. What kind of hair can damaged hair follicles grow?
    white hair
  31. When does wound contraction begin?
    during repair phase
  32. What is the purpose of wound contraction?
    reduces the size of the skin surface wound
  33. How does wound contractions work?
    myofibroblasts in granulation tissue contain muscle fibrils, contract and pull full thickness skin inward
  34. What is granulation tissue?
    new tissue involved in wound healing
  35. What is the purpose of granulation tissue?
    fills in the space (the "hole") and forms a surfce of healing wound
  36. What is granulation tissue composed of?
    fibroblasts and endothelial cells
  37. What are the characteristics of granulation tissue?
    • pink to red
    • bleeds easily
    • granular appearance to surface
  38. What is the function of granulation tissue?
    • fills in tissue defect
    • protects the wound
    • barrier to infection
    • new epithelial cells form across its surface
    • contains myofibroblasts for wound contraction
  39. What are the different types of wound healing?
    • first intention healing
    • second intention healing
    • third intention healing
  40. What kind of wound qualifies for first intention healing?
    wound with little or no tissue loss
  41. First intention healing heals without...
    • infection
    • excessive granulation tissue
    • excessive scarring
  42. What kind of wound is second intention healing?
    some tissue loss - gap between wound edges
  43. Second intention healing wound has _____ granulation surfaces.
  44. What are some reasons to permit healing by second intention?
    • infection
    • cost
  45. What kind of wound is thirst intention healing?
    larger amount of tissue is lost
  46. How does a third intention wound heal?
    • wound is left open to begin healing by second intention
    • time is allowed for granulation bed to form in the wound
    • then the skin edges are debrided and sutured together
  47. What are the factors to wound healing?
    • host factors
    • wound characteristics
    • surgical care
    • wound care
  48. What are the host factors that affect wound healing?
    • age - young or old
    • debilitated, sick, malnourished
    • infection
    • drugs - corticosteroids
  49. What kind of wound characteristics affect healing?
    • amount of debris between wound edges
    • size - small or large
    • location - healing slowed by constant movement
  50. What are the five "surgeon's principles"?
    • asepsis
    • hemostasis
    • gentleness
    • adequate blood supply
    • no tension at healing edges
  51. Why do we bandage a wound quickly?
    • control hemorrhage
    • prevent contamination
  52. How should we care for a wound?
    • clip wound area
    • fill wound with sterile gauze or K-Y jelly first to keep clippings out
    • lavage wound
    • surgical debridement
    • remove contaminated, dead, or devitalized tissue
    • "cut back until it bleeds"
    • surgical closure of wound
    • may place drain
    • may need to bandage
  53. How do we lavage the wound?
    flush with warm sterile saline or water using mild pressure
  54. What is the purpose to flushing out the wound (lavage)?
    • removes debris
    • reduces number of bacteria
Card Set
Wound Healing
Clinical Practice ll