Wound Healing

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What is a wound?

any physical disruption of tissue continuity
What are the different phases of wound healing?
- inflammatory phase
- debridement phase
- repair phase
- maturation phase
What is the first thing that happens during the inflammatory phase?

vasoconstriction slows hemorrhage rate
What occurs within 5 - 10 minutes in the inflammatory phase?

vasodilation
What does vasodilation do during the inflammatory phase?

lets plasma proteins, clotting factors, and WBCs into the wound
What happens after vasodilation during the inflammatory phase?

blood clot forms within wound
What happens after the blood clot forms during the inflammatory phase of wound healing?

scab forms from dried clot
What is the purpose of a scab?

to protect the healing surface of the wound
When does the debridement phase begin?

6 hours after the injury
What happes during the debridement phase?
- WBCs enter wound (segs and monocytes)
- phagocytizes debris - dead tissue and microbes
What forms at the end of the debridement phase?

exudate is formed - WBCs + fluid that has seeped from the wound
When is the repair phase of the wound healing process?

3 - 5 days
What cell types are involved in the repair phase?
- fibroblasts
- endothelial cells
- epithelial cells
What happens during the maturation phase of wound healing?
- collagen organizes along lines of stress
- remodels and shrinks over time
- scar forms
How long does it take for a a minor wound to form a scar?

10 days
When does a scar gain maximum strength?

months to years
Does a scar regain ull normal strength of regular skin?

no
What do fibroblasts look like?

spindle shaped cells
What do fibroblasts do?
- divide to fill space
- make collagen
When do fibroblasts disappear?

in a month or so
What are fibroblasts?

white stands of protein
What are endothelial cells?

cell that line the blood vessels
What do endothelial cells do?

divide to form new blood vessels - bridge the wound
What is granulation tissue composed of?

fibroblasts and endothelial cells
What are epithelial cells?

skin cells
Where do epithelial cells divide in a wound?

at the edge of a wound
What are sutured incisions quickly covered by?

epithelial cells
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
Does new skin make new hair follicles?

no - new skin is hairless
What kind of hair can damaged hair follicles grow?

white hair
When does wound contraction begin?

during repair phase
What is the purpose of wound contraction?

reduces the size of the skin surface wound
How does wound contractions work?

myofibroblasts in granulation tissue contain muscle fibrils, contract and pull full thickness skin inward
What is granulation tissue?

new tissue involved in wound healing
What is the purpose of granulation tissue?

fills in the space (the "hole") and forms a surfce of healing wound
What is granulation tissue composed of?

fibroblasts and endothelial cells
What are the characteristics of granulation tissue?
- pink to red
- bleeds easily
- granular appearance to surface
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
What are the different types of wound healing?
- first intention healing
- second intention healing
- third intention healing
What kind of wound qualifies for first intention healing?

wound with little or no tissue loss
First intention healing heals without...
- infection
- excessive granulation tissue
- excessive scarring
What kind of wound is second intention healing?

some tissue loss - gap between wound edges
Second intention healing wound has _____ granulation surfaces.

two
What are some reasons to permit healing by second intention?
- infection
- cost
What kind of wound is thirst intention healing?

larger amount of tissue is lost
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
What are the factors to wound healing?
- host factors
- wound characteristics
- surgical care
- wound care
What are the host factors that affect wound healing?
- age - young or old
- debilitated, sick, malnourished
- infection
- drugs - corticosteroids
What kind of wound characteristics affect healing?
- amount of debris between wound edges
- size - small or large
- location - healing slowed by constant movement
What are the five "surgeon's principles"?
- asepsis
- hemostasis
- gentleness
- adequate blood supply
- no tension at healing edges
Why do we bandage a wound quickly?
- control hemorrhage
- prevent contamination
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
How do we lavage the wound?

flush with warm sterile saline or water using mild pressure
What is the purpose to flushing out the wound (lavage)?
- removes debris
- reduces number of bacteria

Author

kris10leejmu

172312

Card Set

Wound Healing

Description

Clinical Practice ll

Updated

2012-09-21T02:18:27Z

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