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Questions and Answers
What is wound healing?
A mechanism whereby the body attempts to restore the integrity of the injured part.
What are the phases of normal wound healing?
The inflammatory phase lasts for a week.
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What is granulation tissue?
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What characterizes the remodeling phase of wound healing?
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Which of the following are factors influencing wound healing?
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What type of wound healing involves minimal surrounding tissue trauma?
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Hypertrophic scars can extend beyond the boundary of the original wound.
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What appearance characterizes an atrophic scar?
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What characterizes a keloid scar?
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Study Notes
Wound Healing
- Wound healing is the body's way of restoring injured tissues.
- In healthy people, clean incised wounds heal through three stages:
- Inflammatory phase: This begins immediately after injury and lasts 2-3 days. It involves bleeding, vasoconstriction, and thrombus formation to stop bleeding. Platelets release substances that recruit white blood cells to fight infection.
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Proliferative phase: This lasts from day 3 to week 3. It involves the growth of new tissue called granulation tissue, which contains fibroblasts that build collagen.
- The wound is weak at this stage, and collagen is deposited randomly.
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Remodeling phase: This phase is characterized by collagen maturation, realignment, reduced vascularity, and wound contraction.
- Collagen type 1 replaces type 3 to achieve a 4:1 ratio.
- This phase can take a year or more to complete.
- The wound gains strength, though it may not reach 100% of original tissue strength.
Factors Influencing Wound Healing
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Local Factors:
- Site of the wound
- Structures involved
- Mechanism of wounding (e.g., incision, crush, avulsion)
- Contamination (foreign matter or bacteria)
- Tissue loss
- Vascular insufficiency (arterial or venous)
- Previous radiation
- Pressure
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Systemic Factors:
- Malnutrition or vitamin and mineral deficiencies
- Diseases (e.g., diabetes mellitus)
- Medications (e.g., steroids)
- Immune deficiencies (e.g., chemotherapy, HIV/AIDS)
- Smoking
Wound Healing Classifications
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Primary intention: Wound edges are brought together, resulting in minimal inflammation and a small scar.
- Ex: A surgical incision closed by sutures
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Secondary intention: Wound is left open and heals gradually by granulation, contraction, and epithelialization.
- Ex: A large wound that cannot be closed
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Tertiary intention (delayed primary intention): Wound initially left open (e.g., due to contamination) and later closed when conditions are favorable.
- Ex: A wound that becomes infected
Scars
- Immature Scars: Pink, hard, raised, itchy and become less prominent over time.
- Mature Scars: Paler, softer, flatter, and less itchy.
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Types of Scars:
- Atrophic Scars: Pale, flat, and stretched, often due to acne, chickenpox, surgery, or injuries.
- Hypertrophic Scars: Raised and confined to the original wound area, often result from an extended inflammatory phase or tension across the scar.
- Keloid Scars: Excess scar tissue that extends beyond the original wound, associated with elevated growth factors and genetic predisposition.
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Description
Test your knowledge on the stages of wound healing, including the inflammatory, proliferative, and remodeling phases. Discover the processes involved in how the body restores injured tissues and the timeline for healing. This quiz covers essential concepts for understanding wound care and recovery.
