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40 Cards in this Set
- Front
- Back
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Name the wound healing phases
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1. Inflammation (D 1-10)
2. Proliferation (5 days- 3weeks) 3. Remodeling (3 weeks-1yr) |
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Def: Type III Collagen replaced with Type I; decreased vascularity
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Remodeling Phase
(3 weeks-1yr) |
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Def: PMNs, Macrophages, epithelialization 1-2mm/day
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Inflammation Phase
(Day 1-10) |
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Def: Fibroblast, neovascularization, production of collagen granulation tissue
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Proliferation Phase
(5 days- 3weeks) |
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List the order of CELL arrival in wounds
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1. Platelets
2. PMNs 3. Macrophages 4. Fibroblasts 5. Lymphocytes |
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replace fibronectin-fibrin with collagen
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Fibroblasts
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are esential for wound healing (release of growth factors, cytokins)
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Macrophages
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chemotactic for macrophages, anchors fibroblasts
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Fibronectin
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List the cell type by day for wound healing
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Day 0-2 PMNs
Day 3-4 Macrophages Day 5-on Fibroblasts |
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describe the contents of a provisional matrix
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1. Platelets
2. Fibrin 3. Fibronectin |
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Platelet Alpha Granules
1. Aggregation 2. Binds Thrombin 3. Chemoattractant |
Platelet Alpha Granules
1.Platelet factor 4 2.Beta-thrombomodulin 3.PDGF |
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List the Dense Platelet Granules
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adensosine
serotonin calcium |
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List Platelet aggregation factor
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TXA2
Thrombin Platelet factor 4 |
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Most important factor in healing open wounds (secondary intention)
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Epithelial integrity- migration from wound edges dependent on granulation tissue
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Most important factor in healing closed incisions (primary intention)
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Tensile strength- depeneds on collagen depostion and cross-linking of collagen
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What is the strength layer of the bowel?
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Submucosa
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Weakest time point for small bowel anastomosis
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3-5 days
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Def: smooth muscle cell fibroblast, communicate by gap junctions, involved in wound contraction and healing by secondary intention
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Myofibroblasts
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Name the type of collagen:
Most common type found in skin, bone, and tendons |
Type 1 collagen
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Primary collagen in a healed wound
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Type 1 collagen
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What type of collagen?
Cartilage |
type II
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Type of Collagen?
increased in healing wounds, also found in blood vessels and skin |
Type III collagen
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Type of Collagen?
basement membranes |
Type IV collagen
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Type of Collagen?
found in the cornea |
Type V
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Are required for hydroxylation of proline (prolyl hydroxylase) and subsequent cross-linking of proline residues
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Alpha-ketoglutarate,
Vitamin C, Oxygen Iron |
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Has proline every 3rd amino acid; also has abundant lysine
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collagen
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Disease that results from vitamin C deficiency
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scurvy
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predominant collagen type synthesized for day 1-2 in a wound
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type III collagen
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predominant collagen type synthesized by day 3-4 in a wound
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type III collagen
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What inhibits collagen cross-linking?
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d-Penicillamine
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An Albumin less the __ is a risk factor for poor wound healing
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Albumin < 3.0
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How do steroids prevent wound healing?
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By inhibiting macrophages, PMNs, and collagen synthesis by fibroblasts; decrease wound tensile strength as well
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What vitamin counteracts the effects of steroids on wound healing?
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Vitamin A (25,000 IU qd)
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Name the Dz associated with abnormal wound healing:
Type I collagen defect |
Osteogenesis imperfecta
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Name the Dz associated with abnormal wound healing:
10 types identified, all collagen disorders |
Ehlers-Danlos Syndrome
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Name the Dz associated with abnormal wound healing:
fibrillin defect |
Marfan's syndrome
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Name the Dz associated with abnormal wound healing:
excessive fibroblast, tx phenytoin |
Epidermolysis bullosa
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Def: scar on flexor surfaces of upper torso-- Collagen stays within confines of scar
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Hypertrophic scar tissue
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Def: autosomal dominant collagen goes beyond original scar
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Keloids
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What is the rate of peripheral nerve healing?
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1mm/day
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