Wound Healing and Tissue Repair Overview

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Questions and Answers

What type of healing is primarily associated with gastric erosions?

Primary intention (correct)

Complex intention

Tertiary intention

Secondary intention

Which factors can delay the normal healing process of bone fractures?

Excessive movement and stable fixation

Rapid re-mobilization and age

Mal-union and infection (correct)

Healthy vascularity and nutrition

What is the nature of healing associated with gastric ulcers?

Only secondary intention

Only primary intention

Tertiary intention

A mix of primary and secondary intention (correct)

What effect does aging have on wound healing?

Impaired healing due to weak collagen bonding Signup and view all the answers

Which condition leads to abnormal or delayed healing due to tissue vascularity issues?

Ischemia, causing compromised cellular components Signup and view all the answers

What is the primary nutritional concern that affects collagen synthesis in wound healing?

Vitamin C deficiency leading to scurvy Signup and view all the answers

What complication is associated with excessive cortical bone erosion during fracture repair?

Osteomyelitis leading to delayed union Signup and view all the answers

How does denervation impact wound healing?

Leads to a poor mediation of inflammatory response Signup and view all the answers

Which of the following is a common challenge in achieving normal healing of the liver?

Preservation of extracellular matrix (ECM) Signup and view all the answers

What is a key factor in the healing of mal-union or non-union of fractures?

Appropriate metabolic health of the patient Signup and view all the answers

What is the primary reason for keeping a wound open for 4-7 days during tertiary intention healing?

To allow for secondary healing and granulation tissue formation Signup and view all the answers

Which growth factor is primarily responsible for inducing new blood vessel formation during the angiogenesis phase of wound healing?

Vascular Endothelial Growth Factor (VEGF) Signup and view all the answers

What characterizes granulation tissue during the healing process?

It has a pinkish hue and is composed of new fragile blood vessels. Signup and view all the answers

In the context of scar formation, which cells are primarily involved in the laying of connective tissue over granulation tissue?

Myofibroblasts Signup and view all the answers

What occurs in the second stage of scar formation during wound healing?

Mature collagen replaces the loose ECM and vessels. Signup and view all the answers

Which type of wound healing involves the least amount of tissue loss and is characterized by minimal scarring?

Primary intention Signup and view all the answers

What are the main cells involved in tissue repair during the inflammatory phase of wound healing?

Neutrophils and macrophages Signup and view all the answers

Which phase of wound healing is primarily characterized by collagen deposition and granulation tissue formation?

Proliferative phase Signup and view all the answers

Which of the following factors is least likely to affect wound healing?

Type of antibiotic administered Signup and view all the answers

What complication may arise from delayed wound healing due to insufficient tissue repair?

Keloid formation Signup and view all the answers

Which therapeutic intervention is primarily used to enhance the formation of granulation tissue during the proliferative phase?

Moist wound dressings Signup and view all the answers

Which type of intention healing typically results from surgical intervention with direct closure of the wound?

Primary intention Signup and view all the answers

Which cellular mechanism is crucial for the remodeling and maturation phase of wound healing?

Collagen degradation by matrix metalloproteinases Signup and view all the answers

What is a characteristic feature of a keloid compared to a hypertrophic scar?

It extends outside the boundaries of the wound. Signup and view all the answers

Which complication is most commonly associated with wound dehiscence occurring 5-10 days after suturing?

Weak abdominal muscles. Signup and view all the answers

In the context of wound healing, what does secondary intention primarily involve?

It necessitates scar tissue formation following wound contraction. Signup and view all the answers

Which statement about pathological wound healing is accurate?

Hypertrophic scars involve excessive collagen within wound boundaries. Signup and view all the answers

What role does nutritional status play in wound healing?

It is crucial for collagen production and overall tissue health. Signup and view all the answers

Which mechanism of wound healing typically leads to the formation of scar tissue?

Fibrosis. Signup and view all the answers

Which of the following is not a stage of wound healing?

Reparative phase. Signup and view all the answers

When managing wound dehiscence, what therapeutic intervention is typically employed?

VAC therapy. Signup and view all the answers

What could be a sign of delayed wound healing in a diabetic foot infection?

Decreased tissue perfusion. Signup and view all the answers

What is commonly seen in proud flesh during the wound healing process?

Excessive granulation tissue formation. Signup and view all the answers

What is the primary focus of healing by primary intention?

Minor, clean, sharp cuts with closely apposed edges Signup and view all the answers

Which cell type is primarily responsible for wound contraction during healing?

Myofibroblasts Signup and view all the answers

What characterizes wounds that heal by secondary intention?

They are often kept open to granulate. Signup and view all the answers

What is a potential complication in the healing process associated with intense inflammation?

Increased tissue scarring Signup and view all the answers

In which phase of healing does angiogenesis primarily occur?

Proliferative phase Signup and view all the answers

What therapeutic intervention might enhance the healing process in wounds healing by secondary intention?

Application of drainage systems Signup and view all the answers

Which of the following options best describes a dehisced wound?

A wound that has reopened after initial closure Signup and view all the answers

How does minimal inflammation affect tissue healing?

It promotes rapid re-epithelialization. Signup and view all the answers

What is a key characteristic of wounds with healing by primary intention?

Wounds are sutured with closely apposed edges Signup and view all the answers

What role do fibroblasts play in the healing process?

They are responsible for producing collagen. Signup and view all the answers

Study Notes

Wound Healing and Repair

Wound healing is the restoration of tissue architecture and function after an injury.
It's crucial for survival, eliminating the cause of injury (e.g., pathogens, toxins, or autoimmune complexes).
Healing aims to restore the structure and function to normal.
Terms like repair, regeneration, restoration, and restitution describe the process.
A damaged tissue is considered a wound.

Elements of Tissue Repair

Cells: Crucial components of tissue repair.
Cytokines and Growth Factors (GFs): Proteins that control healing.
Extracellular matrix (ECM): A network of proteins supporting healing.

Session Objectives

Review wound healing (tissue repair) background and definition.
Identify cells, growth factors, and ECM in tissue repair.
Explain healing mechanisms (i.e., primary, secondary, tertiary intention).
Understand scar formation processes.
Analyze factors impacting wound repair.
Summarize examples of dysfunctional wound repair.

Learning Outcomes

Students will describe the pathophysiology of wound healing and repair.
Osteoporosis case studies are included.

Types of Healing

Primary intention: Minor, clean incisions where tissue edges are close together. Healing is relatively fast, with minimal scarring.
Secondary intention: Larger wounds, with edges not approximated, leading to more extensive scarring and a longer healing process.
Tertiary Intention: Wounds that are cleansed, debrided, and left open for healing. Healing occurs as edges are reapproximated, resulting in more scarring than primary intention wounds.

Stages of Wound Repair

Inflammation (Day 0-2): Initial response to injury, characterized by bleeding, coagulation, complement activation, and granulocyte/macrophage activity.
Proliferation (Day 3-5): Cellular proliferation to rebuild structures, including new blood vessels (angiogenesis), collagen synthesis, and epithelialization.
Remodeling (Day 7 onward): Maturation and strengthening of the tissues. Scar tissue formation occurs.

Angiogenesis

Angiogenesis is the formation of new blood vessels.
Growth factors, such as VEGF, FGF-2, PDGF, and TGF-β, are critical for angiogenesis, and are part of tissue healing.
Inflammation causes vasodilation (widening of blood vessels) and increased permeability, supporting the formation of new blood vessels.

Granulation Tissue

Seen as a pink, moist tissue within wounds, granulation tissue contains new blood vessels and migrating cells.
It's indicative of active tissue repair and healing.

Scar Formation

Involves the laying of connective tissue and remodeling.
Myofibroblasts play a vital role in wound contraction. The balance of collagen breakdown and synthesis determines scar appearance.

Factors Affecting Wound Healing

Tissue type
Wound contamination / infection
Age
Nutrition (e.g., vitamin C, protein)
Vascular supply / blood flow
Denervation (nerve damage)
Co-morbidities (e.g., diabetes, immunosuppression)
Steroids

Dysfunctional Wound Healing

Examples of problems include secondary infection, excessive granulation tissue (proud flesh), wound dehiscence, delayed wound healing, hypertrophic scars, keloids, and wound contractures.

Healing of Special Structures

The gastrointestinal tract (GIT) has primary intention healing for erosions and a mix of primary/secondary for ulcers.
The liver's healing is dependent on preserving the ECM, with secondary healing if the ECM is disrupted.
Fractures can have problems like malunion or nonunion.

Interactive Activity

Simulation activities to identify wound types and healing responses.

Case Studies

Pictures and examples of various wound types.
Case studies demonstrating outcomes of diverse wound healing scenarios are incorporated.

Additional Considerations

VAC therapy for wound dehiscence management.
Proper wound assessment and appropriate interventions are crucial for optimal results.
Consult appropriate healthcare professionals for detailed information.

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Description

This quiz covers the essential concepts of wound healing and tissue repair, highlighting the processes involved in restoring tissue architecture and function following an injury. Participants will review the roles of cells, cytokines, growth factors, and the extracellular matrix in healing. Understanding various healing mechanisms and factors affecting wound repair is crucial for comprehending this vital biological process.