Week 8 - Wound Healing Flashcards Preview

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Flashcards in Week 8 - Wound Healing Deck (19)
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How many years does it take for a scar to reach its steady state?

2 years


What % of final strength does a wound have at 3 weeks?

Only 20%


What are some factors that may delay wound healing?

  • Infection
  • Presence of foreign body
  • Diabetes
  • Anaemia
  • Obesity
  • Immobility
  • Poor nutrition
  • Zinc deficiency
  • Age - slower healing in elderly patients
  • Incontinence for sacral wounds
  • Trauma, including artefact


What drugs can delay wound healing?

  • Oral steroids
  • Anticoagulants
  • Retinoids
  • Immunosuppressants


What is this and what bugs commonly cause it?

An infected wound

  • Staph Aureus, Strep A/B orG
  • Occasionally Pseudomonas


What wound is this?

A necrotic wound


What wound is this?

A Granulating Wound

  • A red and well vascularised wound
  • White/pink epithelial tissue coming in from the edges and in islands.


What wound is this?

A Sloughy Wound

  • A yellow/cream exudates consisting of dead cells and protein.
  • Appropriate dressings will help reduce excess exudate.


What is the difference between a keloid scar and an hypertrophic scar?

Keloids are thicker and extend beyond the edge of the wound.


What is the difference between primary and secondary intention healing?

  • Primary intention - wound is sutured closed.
  • Secondary intention - heals without closure.


Why do people get keloid scars?

  • Genetic predisposition (family history)
  • Environmental factors
  • Tension on the scar site.


What are some risk factors for keloid scars?

  • Young age (10-30 years)
  • Familyhistory
  • African-American skin (15-20x more prone)


What are some treatment options for keloid scars?

  1. Remove the keloid lesion- surgery & radiotherapy is the gold standard.
  2. Decrease symptoms and bulk.
    • Steroid injections
      • Triamcinolone 10mg/ml
      • Review at 6 weeks to decide if more needed.
    • Massage- 10 minutes per day.
    • Steroid tape.


When investigating a leg ulcer, what should you do?

  • Document the size, site etc.
  • Doppler - if <0.8 means arterial disease.
  • Swab for infection
  • Consider XR or MRI scan if osteomyelitis suspeced.


What is the treatment for arterial leg ulcers?

  • Stop smoking
  • Exercise
  • Consider vascular surgery


What is the treatment for venous leg ulcers?

Sustained graduated compression


What is the treatment for skin surrounding the wound?

  • Emollients
  • Topical corticosteroids if dermatitis
  • Consider patch test if the dermatitis isn't responding to patch tests.


Venous ulcers are the most common leg ulcers. What are some rarer causes?

  • Rheumatoid arthritis
  • Physical trauma
  • Radiation
  • Vasculitis
  • Infection -mycobacterial, syphilis, yaws, Buruli.
  • Neuropathy
  • Malignancy - SCC or BCC
    • Evolving ulcers can develop into SCC - Marjolin's ulcers.
  • Inflammatory -pyoderma gangrenosum, necrobiosis lipoidica.