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Integumentary Care > Week 1 Wound Healing > Flashcards

Week 1 Wound Healing Flashcards

1
Q

what are the three phases of healing

A

inflammation
proliferation
maturation and remodeling

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2
Q

what two responses do you get in inflammation

A

vascular and cellular response

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3
Q

what is the goal of the vascular response

A

control bleeding, fight infectious agents

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4
Q

describe the vascular response

A

transudate leaks out of the vessel walls, and you get local edema. This cases local blood vessels to constrict. platelets aggregate and active and a plug is formed, which walls off area and closes lymph channels. MORE edema. so chemical mediators are released

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5
Q

within 30 minutes of vasoconstriction, what occurs

A

vasodilation

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6
Q

what 3 things result from vasodilation

A

localized redness, warmth and edema

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7
Q

what are the cardinal signs of inflammation

A

edema, redness, warmth, pain, decreased function

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8
Q

what is the cellular inflammatory response

A

you get an increase in leakiness vessel walls, and pushes polymorphonuclearneutrophils (PMNs) to the sides of the vessel walls. the macrophages arrive and kill pathogens and direct the repair process. Finally, mast cells produce histamine and secrete enzymes to accelerate the riddance of damaged cells

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9
Q

what are the key cells in the cellular inflammatory response

A

platelets, PMNs, macrophages, mast cells

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10
Q

what are the first to arrive at the site of the injury, what do they do? and what do they secrete

A

PMNs arrive within the first 24 hours, kill bacteria and clean, then secrete matrix metalloproteases (MMPs)

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11
Q

what is proliferation

A

this is where you get angiogenesis (formation of new blood vessels), granulation tissue and wound contracture. finally, you get epithelialization

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12
Q

what is angiogenesis

A

formation of new blood vessels

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13
Q

what si granulation tissue

A

fibroblasts lay down extracellular matrix, which will eventually be replaced by scar tissue

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14
Q

what is wound contracture

A

myofibroblasts pull wound margin together

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15
Q

what is epithelialization

A

keratinocytes and epidermal appendages multiply and migrate across the wound bed

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16
Q

what happens in the maturation phase

A

granulation tissue must be strengthened and reorganized, rapid collagen synthesis

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17
Q

how long does maturation last

A

up to 2 years following the wound closure

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18
Q

when do you see the greatest change in the maturation phase

A

in the first 6-12 months

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19
Q

TF: tissue strength returns to 100%

A

false, only 80%

20
Q

TF: you are unable to sweat in a wound

A

true, because you lose the glands.

21
Q

TF: your skin becomes less sensitive to touch and temperature

A

true

22
Q

what are 8 general factors that affect wound healing

A
  • mechanism of onset
  • time since onset (acute or chronic)
  • location (blood supply, bones and prominences)
  • wound dimensions
  • temperature
  • wound hydration
  • necrotic tissue
  • infection
23
Q

does thin or thick skin heal faster

A

thin is faster

24
Q

in what order, in speed of healing, do wounds heal

A

circular is the slowest
then square or rectangle
linear is the fastest

25
Q

what temperature is the best

A

37-38

26
Q

what are the three local factors

A

circulation
sensation
mechanical stress

27
Q

what things fall under the circulation category of local factors

A

macro and micro circulation and SNS response to cold, fear, pain

28
Q

how does sensation affect wound healing

A

decreased knowledge of pain and you can get additional trauma to the area

29
Q

what is mechanical stress

A

friction, shear, weight bearing and pressure

30
Q

what are the 5 systemic factors that affect wound healing

A 
age
nutrition 
cormorbidities 
medications 
behavioral risk taking
31
Q

TF: your immune response is faster when you age

A

false it is slowed

32
Q

TF: you have decreased collagen synthesis as you age

A

true

33
Q

TF: you have epidermal and dermal atrophy

A

true you have thinner skin

34
Q

TF: as you age, you have less sweat and oil glands

A

true

35
Q

TF: you have decreased pain perception and decreased inflammatory response when you age

A

true

36
Q

what other things do you have more of when you age

A

more co-morbidities
more susceptible to infection
more medications

37
Q

what kind of nutrition do we need and why

A

carbs for energy, and protein for cellular repair and regeneration

38
Q

TF: if you are protein deficient, your wounds will heal slower.

A

true

39
Q

TF: you heal slower when you are immunocompromised like when you have HIV AIDS or DM

A

true

40
Q

does oxygen perfusion affect wound healing,

A

yes, like when you have PVD, anemia and COPD and heart conditions

41
Q

how does activity limitations affect wound healing

A

you lose strength and ROM, and have an increase in shear forces in the area, and then decrease in healing

42
Q

how do medications affect healing

A

steroids, chemo and NSAIDS all mess with healing

43
Q

what are some behavioral risks that people take

A

smoking and using alcohol

smoking will decrease oxygen perfusion and alcohol will cause malnutrition and will impair judgement.

44
Q

how does O2 perfusion change 1 hour after smoking

A

decreased by 30%,less oxygen, less healing.

45
Q

what are some inappropriate wound care techniques by the clinician

A
  • prolonged or inappropriate use of antiseptics
  • wrong dressing (dries it out, or too wet)
  • failure to detect and treat
  • inappropriate irrigation and debridement and compression
  • poor wound exploration
  • poor temperature management
46
Q

what are some appropriate wound care things that still affect healing

A
  • initial use of antiseptics to kill all
  • maintenance care is not priority
  • use of iodine to encourage/maintain non-viable tissue desiccation

Integumentary Care (26 decks)

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