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Wound healing phase characterized by PMN�s and macrophages, lasting day 1-10 post-insult
Inflammation
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Wound healing phase characterized by fibroblasts, collagen production, and granulation tissue, lasting 5days-3weeks post-insult
Proliferation phase
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Wound healing phase characterized by replacement of type III with type I collagen
Remodeling
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Order of cell arrival in wound (5 total)
- Platelets
- PMNs
- Macrophages
- Fibroblasts
- Lymphocytes
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Cells essential for wound healing, that release growth factors and cytokines
Macrophages
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Cells that replace fibronectin with collagen
Fibroblasts
-
Material that acts as chemotactic for macrophages and anchors fibroblasts
Fibronectin
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Predominant cell type in wound on day 0-2
PMNs
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Predominant cell type in wound on day 3-4
Macrophages
-
Predominant cell type in wound on day 5+
Macrophages
-
Platelets + fibrin
Platelet plug
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Platelets + fibrin + fibronectin
Provisional matrix
-
Platelet granules that cause aggregation
Platelet factor 4
-
Platelet granules that bind thrombin
Beta-thrombomodulin
-
Platelet chemoattractant
PDGF
-
Platelet aggregation factors (3)
TXA2, thrombin, platelet factor 4
-
Vasodilators released from platelets (2)
PGE2 and PGI1
-
Most important factor in healing open wounds
Epithelial integrity
-
Most important factor in healing cloased incisions
Tensile strength
-
Strength layer of bowel
Submucosa
-
Weakest time point for small bowel anastamosis
3-5 days
-
cells involved in wound contraction and healing by secondary intention
myofibroblasts
-
most common type of collagen; skin, bone and tendons
type I
-
collagen type found in basement membranes
type IV
-
collagen type increased in healing wounds, blood vessels and skin
type III
-
collagen type found in cartilate
type II
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co-factors required for hydroxylation and cross-linking of protein and collagen formation (4)
alpha-ketoglutarate, vitamin C, oxygen, and iron
-
point where a wound reaches maximal tensile strength
8 weeks
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point where a wound is at 80% of final strength and 60% of original strength
6 weeks
-
drug that inhibits collagen cross-linking
d-penicillamine
-
point in wound healing where type III collagen is replaced by type I
3 weeks
-
essentials for wound healing (4)
moisture, oxygen, no edema, no necrotic tissue
-
impediments to wound healing (7)
bacteria >10^5, devitalized tissue, foreign bodies, cytotoxic drugs, diabetes, low albumin, steroids
-
counteracts effects of steroids on wound healing
Vitamin A
-
Cytotoxic drugs that impair wound healing (4)
5FU, methotrexate, cyclosporine, FK-506
-
disorder with a type I collagen defect
osteogenesis imperfecta
-
collagen disorders creating hyperelastic defects
Ehlers-Danlos syndrome
-
Disorder in fibrillin collagen creation
Marfans
-
Disorder of excess fibroblast production
Epidermolysis bullosa
-
Treatment of epidermolysis bullosa
Phenytoin
-
Cause of 90% of leg ulcers
Venous insufficiency
-
Predominant makeup of scar tissue (3)
Proteoglycans, hyaluronic acid, water
-
Tissue type containing no blood vessels
Cartilage
-
Wound healing disorder where collagen goes beyond the original scar
Keloid
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Treatment of keloids
XRT, steroids, silicone, pressure garments
-
Wound healing disorder where collagen stays within the confines of the scar
Hypertrophic scar tissue
-
Treatment of hypertrophic scar tissue
Steroids, silicone, pressure garments
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