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59 Cards in this Set
- Front
- Back
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What are the 3 wound healing phases?
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Inflammation, Proliferation, Remodeling
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What is the timeframe for the inflammation phase of wound healing?
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days 1-10
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What is the timeframe for the proliferation phase of wound healing?
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5 days - 3 weeks
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What is the timeframe for the remodeling phase of wound healing?
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3 weeks - 1 year
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Which phase of wound healing?:
PMNs, macrophages, epithelialization 1-2 mm/day |
Inflammation
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Which phase of wound healing?:
fibroblasts, neovascularization, production of collagen, granulation tissue |
Proliferation
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Which phase of wound healing?:
Type III collagen replaced with type I; decreased vascularity. Net amount of collagen does not change, although significant production and degradation occur. Collagen cross-linking occurs. |
Remodeling
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Peripheral nerves regenerate at ___ mm/day
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1
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Fibroblasts replace fibronectin-fibrin with ___
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collagen
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Chemotactic for macrophages also anchors fibroblasts.
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Fibronectin
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Name the predominant cell type by wound healing day:
Days 0-2 ___ Days 3-4 ___ Days 5 and on ___ |
PMNs,
macrophages, fibroblasts |
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Platelet plug is made of platelets and ___
Provisional matrix is made of platelets, ___ and ___ |
fibrin
fibrin, fibronectin |
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Accelerated wound healing is quicker healing that occurs when reopening a wound the 2nd time. Why does this occur?
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healing cells are already present
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Which type of platelet granules contain: Platelet factor for aggregation. Beta-thrombomomdulin to bind thrombin and PDGF a chemoattractant.
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Alpha granules
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Which type of platelet granule contains adenosine, serotonin and calcium.
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Dense granules
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Name 3 platelet aggregation factors.
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TXA2, thrombin, platelet factor 4
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The most important factor in healing open wounds (secondary intention).
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epithelial integrity
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Epithelial migration occurs from what three places in wound healing?
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wound edges, sweat glands, and hair follicles
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Unepithelialized wounds leak ___ and protein, promote bacterial
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serum
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What is the most important factor in healing closed incisions (primary intention).
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tensile strength
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Tensile strengh depends on what?
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collagen deposition and cross-linking
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What is the strength layer of the bowel?
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submucosa
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What is the weakest time point for small bowel anastomosis?
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3-5 days
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Myofibroblasts communicate by ___
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gap junctions
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What part of wound healing are myofibroblasts involved in?
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wound contraction and healing by secondary intention
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What is the most common type of collagen
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Type I
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Name the type of collagen:
skin, bone and tendons |
I
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Name the type of collagen:
Cartilage |
II
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Name the type of collagen:
increased in wound healing, also in blood vessels and skin |
III
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Name the type of collagen:
basement membranes |
IV
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Name the type of collagen:
widespread, particularly found in the cornea |
V
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Alpha-ketoglutarate, vitamin C, oxygen and iron are required for what part of wound healing?
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hydroxylation of proline and subsequent cross-linking of proline residues
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Collagen has ___ every 3rd amino acid; also has abundant lysine
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proline
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Wound tensile strength is never equal to prewound, only ___%
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80%
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What is the predominant collagen type synthesized for days 1-2?
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Type III
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What is the predominant collagen type synthesized by days 3-4?
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Type I
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Type III collagen is replaced by type I by ___ weeks
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3
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At ___ weeks wound is at 80% of its final strength and 60% of its original strength.
At ___ weeks, wound reaches maximum tensile strength, which is 80% of its original strength |
6
8 |
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Maximum collage accumulation at ___ weeks after that -> the amount of collagen stays the same but continued cross-linking improves strength
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2-3
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d-Penicillamine is used to treat RA, what does it do to wound healing
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inhibits collagen cross linking
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What is the transcutaneous oxygen measurement essential for wound healing?
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> 25 mmHg
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bacteria amount > ___ is an impediment to wound healing
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10^5/cm2
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Albumin < ___ is a risk factor for poor wound healing
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3.0
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Steroids prevent wound healing by inhibiting macrophages, PMNs and collagen synthesis by ___; decreased wound tensile strength as well.
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fibroblasts
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What vitamin (24,000 IU qd) counteracts effects of steroids on wound healing?
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Vitamin A
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Name the disease associated with abnormal wound healing:
Type I collagen defect. |
osteogenesis imperfecta
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Name the disease associated with abnormal wound healing:
10 types identified, all collagen disorders |
Ehlers-Danlos syndrome
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Name the disease associated with abnormal wound healing:
fibrillin (collagen) defect |
Marfan's syndrome
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Name the disease associated with abnormal wound healing:
Excessive firbroblasts. Tx: phenytoin |
Epidermolysis bullosa
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90% of leg ulcers due to ___. Tx?
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venous insufficiency. Unna boot, elastic wrap
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Scar revisions, wait for ___ to allow maturation; may improve with age
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1 year
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What pts heal with little or no scarring?
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infants
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What type of tissue contains no blood vessels
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cartilage
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Does denervation have an effect on wound healing?
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no
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Chemotherapy has no effect on wound healing after ___ days
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14
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What is the inheritance for keloids?
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autosomal dominant
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Tx for keloids?
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XRT, steroids, silicone, pressure garments
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What is the difference between a Keloid and hypertrophic scar tissue.
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Keloids extend beyond original scar
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Hypertrophic scar tissue often occurs in what type of wounds and what is the tx?
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flexor surfaces of upper torso, burns or wounds that take a long time to heal.
Steroids, silicone, pressure garments. |
