wound healing

Question 1

what are the three primary stages of wound healing?

Answer 1

inflammation, proliferation, remodeling

Question 2

what are the three stages of inflammation?

Answer 2

vasoconstriction, hypoxia, and perfusion

Question 3

what mediates vasoconstriction?

Answer 3

norephinephrine

Question 4

what happens if you have too much hypoxia during inflammation stage of healing?

Answer 4

it impairs macrophages and increases risk of infection

Question 5

what occurs during perfusion during the inflammation stage of healing?

Answer 5

vasodilation occurs and this allows for inflammatory cells to get to the wound site

Question 6

What occurs during the proliferation stage of wound healing?

Answer 6

the wound fills in with new tissue and a new capillary bed are put in place

Question 7

what type of collagen is initially laid down in the wound?

Answer 7

type III, more elastic, minimal tensile strength

Question 8

what type of collagen is normal skin?

Answer 8

type I, more tensile strength

Question 9

what is the role of myofibrilblasts?

Answer 9

pull the edges of the wound together

Question 10

what occurs during the remodeling phase of wound healing?

Answer 10

type III collagen is replaced by type I collagen

Question 11

what color is eschar?

Answer 11

black or brown tissue

Question 12

what color is slough?

Answer 12

white, gray, yellow, or tan tissue

Question 13

what color is granulation?

Answer 13

light pink to beefy red

Question 14

what color is epithelialization?

Answer 14

whitish, pale pink to red

Question 15

what color is tendon?

Answer 15

yellow to white

Question 16

what is a big difference between sharps debridement and mechanical debridement?

Answer 16

sharp is selective and mechanical is non selective

Question 17

describe wet to dry dressing

Answer 17

put dressing on for 8 hours, pull off, hope tissue comes with it. Poor option and not effective on dry eschar

Question 18

describe irrigation

Answer 18

spray wound with syringe

Question 19

describe enzymatic debridement

Answer 19

usually used in foreign countries, selective, takes 3-30 days, DON’T USE on clean wounds

Question 20

describe autolytic debridement

Answer 20

selective, basically a mix of macrophages that eat necrotic tissue

Question 21

for autolytic debridement what type of dressing would you use with dry eschar?

Answer 21

film

Question 22

for autolytic debridement what type of dressing would you use with necrotic dry wounds?

Answer 22

hydrogels

Question 23

for autolytic debridement what type of dressing would you use with necrosis?

Answer 23

hydrocolloids

Question 24

when should you not use autolytic debridement?

Answer 24

with a patient who has an active infection!!!!!

Question 25

what is a bright point of hydrogels and hydrocolloids?

Answer 25

they do autolytic debridement once they are placed on.

Question 26

what is the biggest difference between hydrogels and hydrocolloids?

Answer 26

hydrogels won't adhere to wounds and contributes a lot more water

Question 27

what dressing can't be used on a patient with a glycol sensitivity?

Answer 27

hydrogels

Question 28

if you are concerned about hypergranulation which dressing should not be used and why?

Answer 28

hydrocolloids because they cause hyperoxygenation which will accelerate granulation

Question 29

Who should regranex be used on and who should it not be used on?

Answer 29

use on LE diabetic ulcers, DON'T use on patients with known neoplasm

Question 30

what is extra cellular matrix replacement?

Answer 30

really expensive stuff that enhances growth factor

Question 31

why should antiseptics only be used in the early phases of healing?

Answer 31

they kill bacteria but also kill granulation cells so they blunt healing

Question 32

what is a good use for chlorhexidine?

Answer 32

hand sanitizer, not good for much else as it can cause burns

Question 33

what is quaternary ammonium compounds good against?

Answer 33

bacterial gram + and - organisms

Question 34

what is iodine good for?

Answer 34

fungis, viruses, bacteria, and spores. Can damage healing of incisions though

Question 35

cadexomer iodine may improve healing in _________

Answer 35

venous wounds

Question 36

silver release dressings may improve healing in _______

Answer 36

chronic wounds

Question 37

UV light may _______

Answer 37

reduce bacterial load including MRSA

Question 38

what are the benefits of US during the inflammation stage?

Answer 38

It accelerates the inflammation phase, can restart inflammation phase in chronic wounds

Question 39

what are the benefits of US during proliferation?

Answer 39

stimulates angiogenesis, accelerates wound contraction

Question 40

what are the benefits of US during remodeling?

Answer 40

can only help if started in inflammatory phase, increases wound strength, increases elasticity

Question 41

what are the benefits of UV?

Answer 41

initiates inflammatory response, has a bactericidal effect