T1 Lecture 2: Fundamentals of Wound Management Flashcards
Wound healing brings about tissue repair and regeneration and its a fine tune process that culminates in formation of the ____
scar
What are the 4 stages of wound healing in order?
I Demand Rossies Memorize
- Inflammatory phase
- Debridement phase
- Repair
- Maturation/remodeling phase
With wound healing can more than one stage happen at the same time? Do all wounds go through all the phases or can they skip some?
• Significant degree of overlap
so more than one stage may be
occurring simultaneously
• ALL normally healing wounds
must undergo all stages of wound
healing regardless of
size/cause
True or False:
Normal wound healing can bypass certain phases of the 4 step wound healing process.
False
• ALL normally healing wounds must undergo all stages of wound healing regardless of size/cause
Describe what takes place in the first 3-5 days of wound healing, what phases are predominating causing this?
The lag phase of wound healing because inflammation and debridement predominate and wounds have not gained appreciable strength**
Inflammatory phase takes place first within __-__ days
0-5
______ is a protective response initiated by tissue damage
Inflammation
The Inflammatory phase of healing is characterized by the following: (4)
- Increased…..?
- Recruitment of …..?
- Release of _____ and ____
- Activation of these?
– Increased permeability of local blood vessels
– Recruitment of circulatory cells
– Release of growth factors and cytokines
– Activation of neutrophils, lymphocytes, fibroblasts & macrophages
1st response to any injury is?
Hemorrhage (TO BLEED DUHHH)
Describe the general process of inflammation
- Bleeding/Hemorrhage
- ______
- ____ ____
- Vasodilation
- ______ response
- Formation of ______
- Hemorrhage
- Vasoconstriction
- Fibrin clot
- Vasodilation
- Leukocyte response
- Formation of Platelets
During the inflammatory phase after injury takes place and the body responds with hemorrhage?
Describe what takes place next?
What quickly follows after that, why this is taking place?
Vasoconstriction (5-10 min.)
– Next step is to control hemorrhage = Fibrin clot
– Clot also occludes ruptured lymphatics and Prevent drainage/cause edema/localized inflammation = “Glues” wound edges together
After the vasoconstriction, what is next?
Vasodilation to Increased ______ _____
the vessels release ______ ____
(_____ acid cascade) & cellular components
This inflammation lasts ~ __ days
vascular permeability
inflammatory mediators
(arachidonic acid cascade)
~ 5 days
What takes place next in the sequence of inflammation after vasodilation?
State the first responders and then who comes next?
Leukocyte response – PMN’s = 1st responders then macrophages and then T-lymphocytes
Of the leukocytes who arrives first?
PMN’s (polymononuclear neutrophils) = 1st responders
After the leukocytes response next comes platelets and coagulation but these platelets are also responsible for producing?
several cytokines/growth factors important
for progression of wound healing
(Examples) PDGF, transforming growth factor – ⍺ & β, TNF-⍺ = chemotactic for these guys
To transition from inflammatory phase to debridement what takes place next?
White blood cells (The arrival of neutrophils ~6 hr. after wounding & monocytes ~ 12 hrs) leaking from blood vessels into wounds
What is the timing in terms of days with the debridement phase?
2-5 days
Generally, where does debridement take place and what does it cause?
W/in wound bed = Development of an exudate rich in WBC’s, wound fluid & necrotic tissue
Neutrophils Increase in number for 2 - 3 days and there job is to?
Job’s are to prevent infection & phagocytize organisms and debris
What is the significance of degenerating neutrophils in terms of what do they release and facilitate and stimulate?
Degenerating neutrophils release enzymes/toxic oxygen products = Facilitate breakdown of bacteria, extracellular debris/necrotic material & they stimulate monocytes
Compare and contrast monocytes and neutrophils and state who is essential for wound healing and who is not?
*Monocytes: Essential for wound healing (neutrophils/lymphocytes = NOT)!
What are monocytes main role?
Major secretory cells synthesizing growth factors that participate in tissue formation &
remodeling
Monocytes turn into ______ in wounds with __-__ hours
macrophages; 24-48
What are the 3 main roles of macrophages?
- Secrete ____ to removing ______ tissue, bacteria, and ____ ____
- Secrete collagenases removing necrotic tissue, bacteria and foreign material
- Secrete chemotactic & growth factors
- Macrophages also recruit mesenchymal cells, stimulate angiogenesis and modulate matrix production in wounds
