Wound healing

Question 1

Regeneration

Question 2

Resolution

Answer 2

• Returning injured tissue to the original structure and function.
• Can take up to 2 years sometimes.

Question 3

Repair

Answer 3

• Replacement of destroyed tissue with scar tissue.
• Scar tissue.
• Composed primarily of collagen to restore the strength of the tissue but not its function.

Question 4

Healing

Answer 4

• Filling in the wound.
• Sealing the wound (epithelialization).
• Shrinking the wound (contraction)

Question 5

Primary intention

Answer 5

Wounds that heal under conditions of minimal tissue loss.

Question 6

Secondary intention

Answer 6

Wounds that require a great deal more tissue replacement - like an open wound. Heals from the inside out.

Question 7

Inflammation phase

Answer 7

• 24hrs after injury.
• Coagulation
• Infiltration of wound-healing cells
• Angiogenesis

Question 8

Proliferative phase:

Answer 8

• 3-4 days after the initial injury and lasts up to 14 days.
• Granulation: Red, granular tissue. Must be protected, is very susceptible to infection.
• Epithelialization
• Requires fibroblast proliferation, collagen formation, and wound contraction.

Question 9

Remodeling and maturation phase

Answer 9

• Can last weeks to years.
• Continuation of cellular differentiation.
• Scar tissue formation.
• Scar remodeling.

Question 10

Dysfunctional wound healing

Answer 10

• Can occur at any phase of the healing process.
  Caused by:
• Ischemia
• Excessive bleeding
• Excessive fibrin deposition
• Predisposing disorders: Diabetes, Obesity, Wound infection, Inadequate nutrients, Numerous drugs, Tobacco smoking.

Question 11

Dysfunction during reconstruction phase:

Answer 11

• Dysfunctional collagen syntheses: Keloid scar/hypertrophic scar.
• Wound disruption: Dehiscence (the opening of the wound)/Evisceration (contents coming out of the wound). Both increase risk of infections.
• Impaired contraction: Contracture of joints

Question 12

Special consideration in pediatrics

Answer 12

• Neonates have transiently depressed inflammatory and immune function.
• Neutrophils are not capable of efficient chemotaxis.
• Neonates express complement deficiency.
• Deficient in oxidative and bacterial responses.
• Develop overwhelming sepsis.

Question 13

Special consideration in geriatrics:

Answer 13

• Impaired inflammation is likely a result of chronic illness: Diabetes, cardiovascular diseases, etc.
• Chronic medication intake decreases the inflammatory response.
• Healing response is diminished due to loss of the regenerative ability of the skin.
• Infections are more common in the elderly.