Module 5: Altered Healing and Infection

Question 1

One cubic centimetre of skin contains ?

Answer 1

15 Sebaceous Glands
1m Blood Vessels
100 Sweat Glands
3,000 Sensory Cells
4m Nerves
300,000 epidermal cells
2 cold sensors
12 heat sensors
25 pressure sensory cells
200 pain sensors
10 hairs

Question 2

List the Key functions of Skin

Answer 2

Protection, Thermoregulation, Excretion, Metabolism, Sensation, Synthesis and Communication

Question 3

Name the 4 Stages of wound healing

Answer 3

1. Haemostasis
2. Inflammatory Phase
3. Proliferative Phase
4. Remodelling Phase

Question 4

Describe Haemostasis

Answer 4

• Occurs at time of injury and up to 3 hours after
• Biochemical response in which clotting factors are released to extravascular tissue.
• Activates platelets to form a plug at wound site
• Fibrin strengthens platelet formation

Question 5

Describe Inflammatory Stage

Answer 5

• 0-4 Days
• Vascular and cellular response, involves the recruitment and activation of inflammatory cells
• Vasodilation, vasoconstriction, increased vascular permeability
• Inflammatory cells, WBC, growth factors, nutrients and enzymes are attracted to the site by macrophages.
• Results in swelling, redness and pain

Question 6

Describe Proliferative (Reconstructive) Phase

Answer 6

2-24 days

Fibroblasts manufacture collagen and begin to rebuild the wound site, tissue is very delicate and high nutrients are needed at this point

Some processes during this stage include
angiogenesis (New blood vessels)
granulation (particle enlargement)
contraction (reduced tissue defecation)
epithelialisation (covering tissue

Question 7

Describe remodelling (Maturation) Phase

Answer 7

24 days to a year

Scar tissue is remodelled and strengthened by synthesis of collagen and elastin (laying more foundations for collagen to strengthen itself)

Question 8

Name some types of aberrant healing

Answer 8

Hypergranulation
contracture
keloid
hypertrophic scar

Question 9

Describe acute wound

Answer 9

Any surgical wound that heals by primary intention
OR
Any traumatic or surgical wound which heals by secondary intention
AND
proceeds through an orderly and timely reparative process that results in sustained restoration of anatomical integrity

Question 10

Describe Chronic Wound

Answer 10

When the reparative process does not proceed through an orderly and timely process as anticipated
AND
where healing is complicated and delayed by factors that impact on the PERSON, WOUND OR ENVIRONMENT

Question 11

Name some general factors that inhibit healing

Answer 11

Ageing Process
smoking
nutritional status
BMI
Medications
allergies
chemo
comorbodities

Question 12

Name some components of ageing skin

Answer 12

epidermis thins and flattens
decreased vascularity of the dermis
changes to and loss of collagen
decreased number of oil and sweat glands
more fragile
the vascular response is compromised

Question 13

Name the nutrients essential for wound healing

Answer 13

Proteins
carbohydrates
fats
vitamins
major/minor trace elements
fluid

Question 14

Medications that impact healing ?

Answer 14

corticosteroids
cytotoxic agents
NSAIDs
Some antibiotics

Question 15

what are some physical complications does nicotine smoking results in ?

Answer 15

increased vasoconstriction
increased platelet aggregation
impaired collagen synthesis
impaired epithelialisation
reduced tissue oxygenation

Question 16

Phychosocial Implications of nicotine smoking

Answer 16

fatigue, anger and depression
self-esteem issues
familial responsibilities challenged
social responsibilities challenged
employment issues
economic constraints

Question 17

How does obesity impacts on healing ?

Answer 17

Adipose tissue is poorly vascularised (become vascular- provide blood)
Poor nutritional habits impacts healing (not enough nutrients)
Inhibited movement results in pressure ulcers and increases DVT risk

Question 18

How does Cachexia (anorexia) inhibit healing ?

Answer 18

Malnutrition inhibits metabolic processes
reduced ability to dissipate pressure

Question 19

Define wound infection

Answer 19

The invasion of a wound by proliferating microorganisms to a level that invokes a local or systemic response in the host
impedes wound healing
intervention is generally required

Question 20

Describe granulocytes

Answer 20

Small WBC which contains proteins to help fight bacterial infections

Question 21

describe monocytes

Answer 21

type of immune cell made in the bone marrow which travels through the blood to tissues in the body where it becomes a macrophage

Question 22

describe macrophages

Answer 22

type of WBC that ingulfs and digests microorganisms, clears dead cells and stimulates other cells involved in immune function

Question 23

describe lymphocytes

Answer 23

type of immune cells that is made in the bone marrow and is found in the blood and lymph tissue.