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Dermatology > Wound Healing > Flashcards

Wound Healing Flashcards

1
Q

Define wound

A

Loss of integrity of skin tissue

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2
Q

What can cause chronic wounds?

A

Disruption in normal healing process
- aetiology go wound
- location
- tissue type

Slowed/incomplete healing

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3
Q

What are the 3 phases of wound healing?

A

Inflammatory phase (0-48 hours)
Proliferation phase (48hours - 6 weeks)
Maturation and remodelling phase (3 weeks - 1/2 years)

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4
Q

Clinical signs of inflammatory phase

A

Rubor
Calor
Dolor
Tumor

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5
Q

Phat are the 3 main phases of the inflammatory phase?

A

Wound cleaning (phagocytosis)
Chemoattraction
Structural framework development (temporary matrix)

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6
Q

Clinical signs of the proliferative phase

A

No inflammatory signs
Reduced swelling
Reduced wound size (contraction)
Itch

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7
Q

Describe the concepts in the proliferative phase

A

Net collagen synthesis
Increased wound tension strength
- epidermal cells proliferate and move to wound eggs to granulation tissue - closes wound
- wound contraction via forces within myofibroblasts
Scar formation
- apoptosis of immune cells, fibroblasts, endothelial cells
- remaining fibroblasts for laying down collagen

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8
Q

What happens in the maturation and remodelling phase?

A

Reorganisation of collagen

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9
Q

What factors can affect the duration of the maturation and remodelling phase?

A

Age
Wound type (burns take a long time to heal)
Body location
Duration of inflammatory phase

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10
Q

What can affect wound healing?

A

Size of wound
Blood supply to area
Presence of foreign bodies or microorganisms
Age and health of patient
Nutritional status
Drugs

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11
Q

What is primary intention?

A

Immediate closure of wound edges when no loss of tissue has occurred
Rapid epithelial cover, faster healing, better cosmetic result
Eg. Surgical incision

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12
Q

What is secondary intention?

A

Spontaneous healing of wound without direct closure (intentionally left open)
Granulation, slow epithelial cover, wound contraction, compromised cosmetic result
Eg. Excessive trauma, difficult wound closure, tissue loss

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13
Q

What is tertiary intention?

A

Initially left open after removal of all non-viable tissue
Wound edges brought together a few days later
- when wound appears clean and well vascularised
- before granulation tissue is visible
Eg. Traumatic injury, dirty surgery, delayed primary intention of surgical wounds

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14
Q

How does cryotherapy cause cell death?

A

Ice crystal formation
Osmotic differences -> cell disruption
Ischaemic damage
Immunologic stimulation

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15
Q

Cryotherapy indications

A

Actinic keratosis
Viral warts
Seborrhoeic wart
Molluscum contagiousum
Myxoid cyst
Bowen’s disease
Superficial BCC

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16
Q

Cryotherapy contraindications

A

Pigmented lesions
Malignant lesions (needs histology, I’ll-defined borders)
Cold urticaria
Lesion of uncertain diagnosis

17
Q

Efudix indications (5-Flurouracil)

A

Superficial BCCs
Multiple actinic keratoses
Bowen’s disease

18
Q

What is photodynamic therapy?

A

Activation of topical porphyrin cream to destroy cancer or pre-cancer

19
Q

Photodynamic therapy indications

A

Actinic keratosis
Bowen’s disease
Superficial BCC
Multiple or large lesions

20
Q

Photodynamic therapy contraindications

A

Pigmented lesions
Malignant lesions (requires histology)
Patients unable to tolerate pain

21
Q

What is curettage and cautery?

A

Scraping off lesion and applying heat to skin surface for haemostasis

22
Q

Curettage and cautery indications

A

Pyogenic granuloma
Cutaneous horn/actinic keratosis
Large seborrhoeic wart
Small Nodular BCCs

23
Q

Curettage and cautery contraindications

A

Pigmented lesions
BCCs (morphoeic, infiltrating, Ill-defined)
BCCs on sites with high recurrence rate (nose, nasolabial fold, eye area, ear, scalp)
Most SCCs

24
Q

What is a shave excision?

A

Lesion raised by local anaesthetic, lesion is shaved off and heat is applied to skin surface for haemostasis

25
Q

Shave excision indications

A

Chondrodermatitis nodularis helix is
Benign naevi

26
Q

Shave excision contraindications

A

Keratoacanthoma vs SCC
Melanomas
Don’t shave potential cancers

27
Q

Excision biopsy indications;

A

Suspected tumours
Pigmented lesions

28
Q

Excision biopsy contraindications

A

No (valid) consent
INR too high or under preparation with anti platelets/anticoagulants (deeper cut, more vasculature, higher bleeding risk)
Pacemaker check (bipolar current used to close vessels, lidocaine anaesthetic can be a cardiac depressant and reduce heart rate)

29
Q

What is Moh’s surgery?

A

Micrographic surgery
Removing lesions, examining under microscope and continue to excise until all lesion removed

30
Q

Moh’s surgery indications

A

Recurrent
High risk zone
Aggressive growth
>2cm off face
>0.5cm on face
Incomplete excision
Ill-defined borders

Dermatology (23 decks)

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