VN Q2 Wound Healing
Terms
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- Define wound
- break in normal structure of tissues
- Steps in wound healing
-
wound
bleeding
constriction, then dilation
plasma proteins, WBC, antibodies enter site - Scab
- dried up blood, protects wound
- 1st intention healing
-
ideal, sx incision
well apposed epithelial cells
2 days: bridged, debris largely eliminated, fibroblasts apear & produce collagen fibers
Day 4-5: continue to lay fibers
Day 10: layers strong enough to hold themselves (SR)
1 month: fibroblasts gone - 2nd intention healing
-
scab
apposition
fibroblasts & collogen form under scab
cells move to close the wound
Day 5-6: wound shrinks - Define apposition
- budding of tissue in correct manner
- Factors increasing healing time
-
movement
bacterial contamination
licking
age
disease - Stages of wound healing
-
inflammatory
debridement
repair
maturation - Inflammatory Phase
-
time of wounding
bleeding removes debris
clot provides stability
chemical mediators released
influx of WBC, RBC, plasma proteins
redness, pain, heat, swelling - Debridement Phase
- WBC attack debris
- Repair Phase
-
capillaries form
granulation
epithelial cells migrate
early wound strength (15 days) - Maturation Phase
-
collagen fibers remodelled
scar contracts
over year
80-85% skin & fascia strenght returned - Clean wound
-
elective sx
aseptic - Clean contaminated wound
-
residual bacterial flora
asceptic technique
bone fracture, intestinal tract contents - Infected wound
-
inflammed, contaminated, a lot of bacteria
abcess, FB, puss - 3rd intention healing
-
delayed primary closure
contaminated/infected
sx debridement of tissue