Fiser ABSITE Ch. 14 Wound Healing Flashcards Preview

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Flashcards in Fiser ABSITE Ch. 14 Wound Healing Deck (61):
1

What are the 3 wound healing phases?

Inflammation, Proliferation, Remodeling

2

What is the timeframe for the inflammation phase of wound healing?

days 1-10

3

What is the timeframe for the proliferation phase of wound healing?

5 days - 3 weeks

4

What is the timeframe for the remodeling phase of wound healing?

3 weeks - 1 year

5

Which phase of wound healing?:
PMNs, macrophages, epithelialization 1-2 mmday

Inflammation

6

Which phase of wound healing?:
fibroblasts, neovascularization, production of collagen, granulation tissue

Proliferation

7

Which phase of wound healing?:
Type III collagen replaced with type I; decreased vascularity. Net amount of collagen does not change, although significant production and degradation occur. Collagen cross-linking occurs.

Remodeling

8

Peripheral nerves regenerate at ___ mmday

1

9

Fibroblasts replace fibronectin-fibrin with ___

collagen

10

Chemotactic for macrophages also anchors fibroblasts.

Fibronectin

11

Name the predominant cell type by wound healing day:
Days 0-2 ___
Days 3-4 ___
Days 5 and on ___

PMNs
macrophages
fibroblasts

12

Platelet plug is made of platelets and ___

fibrin

13

Provisional matrix is made of platelets, ___ and ___

fibrin, fibronectin

14

Accelerated wound healing is quicker healing that occurs when reopening a wound the 2nd time. Why does this occur?

healing cells are already present

15

Which type of platelet granules contain: Platelet factor for aggregation. Beta-thrombomomdulin to bind thrombin and PDGF a chemoattractant.

Alpha granules

16

Which type of platelet granule contains adenosine, serotonin and calcium.

Dense granules

17

Name 3 platelet aggregation factors.

TXA2, thrombin, platelet factor 4

18

The most important factor in healing open wounds (secondary intention).

epithelial integrity

19

Epithelial migration occurs from what three places in wound healing?

wound edges, sweat glands, and hair follicles

20

Unepithelialized wounds leak ___ and protein, promote bacterial

serum

21

What is the most important factor in healing closed incisions (primary intention).

tensile strength

22

Tensile strengh depends on what?

collagen deposition and cross-linking

23

What is the strength layer of the bowel?

submucosa

24

What is the weakest time point for small bowel anastomosis?

3-5 days

25

Myofibroblasts communicate by ___

gap junctions

26

What part of wound healing are myofibroblasts involved in?

wound contraction and healing by secondary intention

27

What is the most common type of collagen

Type I

28

Name the type of collagen:
skin, bone and tendons

I

29

Name the type of collagen: Cartilage

II

30

Name the type of collagen: increased in wound healing, also in blood vessels and skin

III

31

Name the type of collagen: basement membranes

IV

32

Name the type of collagen: widespread, particularly found in the cornea

V

33

Alpha-ketoglutarate, vitamin C, oxygen and iron are required for what part of wound healing?

hydroxylation of proline and subsequent cross-linking of proline residues

34

Collagen has ___ every 3rd amino acid; also has abundant lysine

proline

35

Wound tensile strength is never equal to prewound, only ___%

80%

36

What is the predominant collagen type synthesized for days 1-2?

Type III

37

What is the predominant collagen type synthesized by days 3-4?

Type I

38

Type III collagen is replaced by type I by ___ weeks

3

39

At ___ weeks wound is at 80% of its final strength and 60% of its original strength.

6

40

At ___ weeks, wound reaches maximum tensile strength, which is 80% of its original strength

8

41

Maximum collage accumulation at ___ weeks after that -> the amount of collagen stays the same but continued cross-linking improves strength

2-3

42

d-Penicillamine is used to treat RA, what does it do to wound healing

inhibits collagen cross linking

43

What is the transcutaneous oxygen measurement essential for wound healing?

> 25 mmHg

44

bacteria amount > ___ is an impediment to wound healing

10^5cm2

45

Albumin less than ___ is a risk factor for poor wound healing

3

46

Steroids prevent wound healing by inhibiting macrophages, PMNs and collagen synthesis by ___; decreased wound tensile strength as well.

fibroblasts

47

What vitamin (24,000 IU qd) counteracts effects of steroids on wound healing?

Vitamin A

48

Name the disease associated with abnormal wound healing: Type I collagen defect.

osteogenesis imperfecta

49

Name the disease associated with abnormal wound healing: 10 types identified, all collagen disorders

Ehlers-Danlos syndrome

50

Name the disease associated with abnormal wound healing: fibrillin (collagen) defect

Marfan's syndrome

51

Name the disease associated with abnormal wound healing: Excessive firbroblasts. Tx: phenytoin

Epidermolysis bullosa

52

90% of leg ulcers due to ___. Tx?

venous insufficiency. Unna boot, elastic wrap

53

Scar revisions, wait for ___ to allow maturation; may improve with age

1 year

54

What pts heal with little or no scarring?

infants

55

What type of tissue contains no blood vessels

cartilage

56

Does denervation have an effect on wound healing?

no

57

Chemotherapy has no effect on wound healing after ___ days

14

58

What is the inheritance for keloids?

autosomal dominant

59

Tx for keloids?

XRT, steroids, silicone, pressure garments

60

What is the difference between a Keloid and hypertrophic scar tissue.

Keloids extend beyond original scar

61

Hypertrophic scar tissue often occurs in what type of wounds and what is the tx?

flexor surfaces of upper torso, burns or wounds that take a long time to heal; Steroids, silicone, pressure garments.