Wound Healing

Question 1

What is the body’s largest organ?

Answer 1

Integumentary system (Skin)

Question 2

What layers make up the integumentary system?

Answer 2

Epidermis
Dermis
Subcutaneous fatty tissue

Question 3

What is the most superficial layer of skin?

Answer 3

Epidermis

Question 4

What layer of skin is considered the true skin?

Answer 4

Dermis

Question 5

Distinguish which layers of skin are vascular versus avascular.

Answer 5

Epidermis = avascular 
Dermis = vascular

Question 6

What are the five key functions of the integumentary system?

Answer 6

Protection
Sensation
Thermoregulation
Excretion of sweat
Vitamin D synthesis

Question 7

What are the 3 phases of wound healing?

Answer 7

Phase 1: Inflammatory
Phase 2: Proliferative
Phase 3: Maturation

Question 8

How long does the inflammatory phase last?

Answer 8

1-10 days

Question 9

How long does the proliferative phase last?

Answer 9

3-21 days

Question 10

How long does the maturation phase last?

Answer 10

7 days to 2 years

Question 11

What is the immune system’s initial response to a wound?

Answer 11

Inflammation

Question 12

How does the body rapidly establish homeostasis in the presence of a wound? What phase does this occur in?

Answer 12

Through platelet activation and the clotting cascade

Occurs in the INFLAMMATORY phase

Question 13

What 4 things occur in the inflammatory phase of wound healing?

Answer 13

1. Re-establish homeostasis via platelet and clotting cascade activation
2. Removal of debris and necrosis
3. Bacteria killed by mast cells, neutrophils and leukocytes
4. Re-epithelization

Question 14

What is the main goal of the inflammatory phase of healing?

Answer 14

Establish a clean wound bed which signals tissue restoration and the start of permanent wound healing

Question 15

When does re-epithelization typically begin?

Answer 15

Within 24 hours

Question 16

What signals the beginning of the proliferation phase?

Answer 16

Formation of new tissue

Question 17

What is restored during the proliferative phase?

Answer 17

Skin integrity

Question 18

What 3 things occur in the proliferative phase of wound healing?

Answer 18

1. Capillary buds and granulation tissue fill the wound bed
2. Collagen matrix is formed
3. Epithelization and wound contraction

Question 19

What 2 processes give rise to wound closure?

Answer 19

Epithelization

Wound contraction

Question 20

When is the maturation phase initiated?

Answer 20

When granulation tissue and epithelial differentiation appear in the wound bed

Question 21

What 2 things occur in the maturation phase of wound healing?

Answer 21

1. Fiber reorganization and contraction shrink the scar

2. Collagen lysis and synthesis strengthen the scar tissue

Question 22

What 2 processes shrink the scar tissue?

Answer 22

Fiber reorganization and contraction

Question 23

What 2 processes strengthen the scar tissue?

Answer 23

Collagen lysis and synthesis

Question 24

What are characteristics of an immature scar?

Answer 24

Red
Raised
Rigid

Question 25

What are characteristics of a mature scar?

Answer 25

Pale Flat Pliable

Question 26

Newly repaired tissues have approximately ____ % of pre-injury tensile integrity and should be protected to prevent re-injury.

Answer 26

15%

Question 27

Over time tensile integrity may increase to up to ___ % of pre-injury strength.

Answer 27

80%

Question 28

What condition can significantly impact the maturation phase of healing?

Answer 28

Hypertrophic scarring

Question 29

What type of wounds are typically treated with healing by primary intention?

Answer 29

Acute wounds with minimal tissue loss

Question 30

What is healing by primary intention?

Answer 30

Closing the edge of a wound with sutures, staples or adhesives to facilitate re-epithelization

Question 31

Provide 4 examples of wounds that heal via primary intention.

Answer 31

Surgical incision Laceration Puncture Superficial and partial thickness wounds

Question 32

What type of healing is used to treat a puncture or laceration wound?

Answer 32

Primary intention

Question 33

What is healing by secondary intention?

Answer 33

Permitting the wound to close on its own without superficial closure

Question 34

List 4 characteristics of wounds that heal via secondary intention.

Answer 34

1. Significant tissue loss 2. Necrosis 3. Irregular wound margins 4. Infection or debris contamination

Question 35

Wounds that heal via secondary intention require ____ and have significantly larger _____ than wounds that heal via primary intention.

Answer 35

Require ongoing wound care | Larger scars

Question 36

What wounds typically heal via secondary intention?

Answer 36

Pressure Ulcers | Full Thickness wounds

Question 37

What is an alternative name for healing by tertiary intention?

Answer 37

Delayed primary intention healing

Question 38

What is healing by tertiary intention?

Answer 38

Wounds at risk for developing complications are left open until risk factors are dealt with, and then the wound is close via primary intention.

Question 39

What kinds of wounds may be treated with tertiary intention?

Answer 39

Contaminated wounds Infected wounds Sepsis

Question 40

What are 8 factors that influence wound healing?

Answer 40

1. Age 2. Co-morbidities 3. Edema 4. Harsh/Inappropriate wound care 5. Infection 6. Lifestyle 7. Medication 8. Obesity

Question 41

What is the difference between contamination, colonization and infection?

Answer 41

Contamination = nonreplicating bacteria on wound surface that do not cause further damage; do no stimulate inflammatory process Colonization = replicating bacteria on wound surface that do not cause further damage; do no stimulate inflammatory process Infection: replicating bacteria viable beyond the wound surface that causes further damage; stimulates the inflammatory process