Wound Healing and Repair
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Questions and Answers

What is the main difference between regeneration and repair?

  • Regeneration is a slower process, whereas repair is a faster process
  • Regeneration involves the formation of granulation tissue, whereas repair involves the formation of fibrous scar tissue
  • Regeneration involves the proliferation of surrounding undamaged cells, whereas repair involves the formation of granulation tissue (correct)
  • Regeneration is a response to minor injuries, whereas repair is a response to major injuries

    • What is the primary difference between primary and secondary intention healing?

  • The width of the wound edges (correct)
  • The presence of infection
  • The size of the wound
  • The type of tissue involved

    • Which stage of healing is characterized by the formation of a fibrin clot and is inhibited by aspirin and warfarin?

  • Haemostasis (correct)
  • Granulation tissue formation
  • Re-epithelialisation
  • Inflammation

    • What is the main role of macrophages during the inflammatory stage of healing?

    <p>To facilitate debridement</p> Signup and view all the answers

    What is the primary mechanism by which the wound area is reduced during secondary intention healing?

    <p>Contraction</p> Signup and view all the answers

    What is the duration of the granulation tissue formation stage of healing?

    <p>2-5 days</p> Signup and view all the answers

    What is the primary function of macrophages in wound healing?

    <p>Phagocytosis, protease synthesis, and regulation of immune cell function</p> Signup and view all the answers

    What is the result of collagen cross-linking in wound healing?

    <p>Maturation of connective tissue</p> Signup and view all the answers

    What is the primary factor affecting wound healing in Afro-Caribbean populations?

    <p>Keloid formation</p> Signup and view all the answers

    What is the primary function of fibroblasts in wound healing?

    <p>Synthesizing collagen matrix</p> Signup and view all the answers

    What is the primary complication of wound healing resulting in break down of the wound?

    <p>Wound dehiscence</p> Signup and view all the answers

    What is the primary factor affecting wound healing in patients with pre-existing medical conditions?

    <p>Diabetes</p> Signup and view all the answers

    What is the primary function of endothelial cells in wound healing?

    <p>Forming blood vessels</p> Signup and view all the answers

    What is the primary difference between keloids and hypertrophic scarring?

    <p>Keloids spread beyond the original wound margins</p> Signup and view all the answers

    What is the primary systemic factor affecting wound healing?

    <p>Ageing</p> Signup and view all the answers

    What is the primary local factor affecting wound healing?

    <p>Blood supply</p> Signup and view all the answers

    Study Notes

    Wound Healing

    • Regeneration: replacement of lost or damaged tissue by that of a similar type, derived from the proliferation of surrounding undamaged cells.
    • Repair: replacement of lost or damaged tissue by granulation tissue, which later matures into fibrous scar tissue.

    Healing Routes

    • Helpful route: healing
    • Not helpful route: fibrosis/scar formation

    Primary and Secondary Intention Healing

    • Primary intention: wound is narrow, wound edges are in close apposition, re-epithelialisation dominates healing.
    • Secondary intention: wound is more extensive, wound edges are widely separated, granulation tissue covers the wound and the wound area is reduced by contraction.

    Stages of Healing

      1. Haemostasis (1 hour): platelet plug formation, fibrin clot formation
      1. Inflammation (48 hours): macrophage infiltration, debridement
      1. Granulation tissue formation (2-5 days): endothelial cell and fibroblast proliferation, new blood vessels migrate from wound edges, collagen extra-cellular matrix
      1. Maturation of connective tissue (5+ days): decreased cellularity, decreased vascularity, remodelling of collagen matrix, collagen cross-linking
      1. Re-epithelialisation (1-3 days): proliferation of basal epithelial cells, migration of basal epithelial cells across wound bed, epithelial cells differentiate and stratified squamous structures reform

    Haemostasis

    • Consists of: platelet plug formation, fibrin clot formation
    • Inhibited by: aspirin, warfarin, factor VIII deficiency

    Inflammation

    • Caused by: macrophage infiltration

    Granulation Tissue

    • Forms through: endothelial cell and fibroblast proliferation, new blood vessels migrate into damaged area, fibroblasts lay down collagen extra-cellular matrix
    • Consists of: fibroblasts, blood vessels, inflammatory cells

    Maturation of Connective Tissue

    • Results in: decreased cellularity, decreased vascularity, remodelling of collagen matrix, collagen cross-linking

    Re-epithelialisation

    • Occurs through: proliferation of basal epithelial cells, migration of basal epithelial cells across wound bed, epithelial cells differentiate and stratified squamous structures reform

    Factors Affecting Wound Healing

    • 3 systemic factors: ageing, nutritional status, iatrogenic, pre-existing medical conditions
    • 7 local factors: blood supply, infection, persistent irritation, poor wound stability, poor apposition of wound edges, direction of incision, ionising radiation
    • 3 factors important in controlling wound healing: cell-cell interactions, cell-matrix interactions, autocrine/paracrine interactions

    Macrophages

    • 3 traditional functions: phagocytosis, protease synthesis, regulation of immune cell function
    • 4 additional functions: fibroblast recruitment, extra-cellular matrix synthesis, platelet recruitment, growth of blood vessels

    Complications of Wound Healing

    • 5 complications: wound dehiscence, contractures, keloid/hypertrophic scar formation, weak scars, pigmentation

    Keloids and Hypertrophic Scarring

    • Keloid: sharply elevated, progressively enlarging scar characterised by excessive collagen formation in the dermis
    • 2 differences between keloids and hypertrophic scarring: keloids may spread beyond the margins of the original wound, hypertrophic scars do not; keloids are mainly found in Afro-Caribbean populations, hypertrophic scarring affects varied population groups
    • 1 similarity: seen on the face but does not affect the oral mucosa

    Embryonic and Oral Mucosal Wound Healing

    • Embryonic wound healing: peculiar due to absence of scarring, possibly due to immaturity of immune system
    • Oral mucosal wound healing: peculiar due to less scarring than skin, no keloids/hypertrophic scarring, immune response seems different

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    Description

    This quiz covers the concepts of regeneration and repair in wound healing, including the differences between primary and secondary intention healing. Test your knowledge of the helpful and not-so-helpful routes of repair and the characteristics of granulation tissue and fibrous scar tissue.

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