3220: wound healing

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jam110007
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236779
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3220: wound healing
Updated:
2013-09-24 22:53:25
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wound healing 3220
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would healing 3220 exam 1
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  1. name the 2 tissue types
    • - parenchymal 
    • - stromal
  2. parenchymal tissue
    working cells that are doing whatever that particular organ does
  3. stomal tissue
    structural net hols the parenchymal tissue in place [supplies it with nutrients and gives i structure], structures tissue
  4. would healing invloves ?...
    • - regeneration of dead parenchymal working class
    • - connective tissue repair
  5. 2 ways in which wound heals
    • - primary intention 
    • - secondary intention
  6. phases of would healing include?
    • 1. inflammatory response [clean up phase]
    • 2. proliferative [reconstruction phase]
    • 3. remodeling [maturation phase]
  7. what does proliferation mean
    make more of the same thing
  8. what does differentiation mean?
    become more specialized for a specific function
  9. stem cells
    in-differentiated cells, can make many type of cells
  10. which cells can regenerate?
    • -continuously dividing cells
    • - stable cells
    • - permanent cells
  11. continuously dividing cells
    • constantly replaced 
    • - such as the skin, bone marrow, and linings. must have bank of stems
  12. stable tissues
    • normally stop dividing, held in quiet stage of cell cycle, but can turn on production as stimulated 
    • - smooth mucle, parenchyma, fibroblasts
  13. permanent cells
    • - no proliferation, very differentiated
    • - nerves, heart muscle
  14. woulds healing is regulated by what?
    chemical mediators, and growth factors
  15. where does regulation of wound healing take place?
    in the extracellular matrix
  16. scar tissue is fibrous due to what?
    due to collagen deposition which creates a strong bond to hold the area together
  17. what are adheasions?
    • - they are extra scar tissue that can cause that sticks to other organs etc. their not supposed to 
    • - functional problems and discomfort and also a pulling sensation
  18. how long does it take to start scar formation
    2 days - 3 weeks +
  19. what are the 3 phases of scar formation
    • - angiogenesis 
    • - firoblasts and ECM depositions 
    • - maturation and remodeling
  20. angiogensis and granulation
    • - first phase of scar formation 
    • - angiogensis: formation of new baby blood vessels, need Nitric oxide 
    • - granulation: tissue fills in, made of new capillaries, fibroblasts, and inflammation tissue
  21. how does granulation tissue look like?
    • - red
    • - moist
    • - meaty looking
    • - granular
    • - bleed easily, puffy
  22. fibroblasts and EMC deposition
    • - fibroblasts secrete collagen in fibrous strands
    • - collagen created a scaffold of strength 
    • - other ECM deposited in wound
    • - in skin wounds, epithelial cells seal wound in 24-48 hours, "approximated" wounds heal faster, epitheliaization is the bridging of the would with skin (epithelial) cells
  23. remodeling (maturation) phase
    • - scar matures, blood vessels retreat, scar turns paler, avascular, with stress lines
    • - tensile strength increases 70% with sutures, to 10 % increases up to 70 or 80 by three months
  24. primary intention healing
    • - is your basic, good, fast healing 
    • - not a lot of missing or dead cells to replace, edges of would come together, no foreign bodies, dirt, infection
  25. secondary intention healing
    is complicated, missing, chunks, infected, foreign bodies, edges of would don't come together
  26. how do nurses check the healing process
    they use the "REEDA" tool
  27. what is the REEDA tool?
    • it stands for
    • - redness
    • - edema
    • - ecchymosis
    • - drainage 
    • - approximation
  28. factors which delay wound healing
    • - nutritional deficiencies
    • - inadequate blood supply 
    • - disease 
    • - poor circulation 
    • - corticosteriod drugs
    • - infection 
    • - mechanical friction on wound
    • - advanced age
    • - obesity 
    • - poor general health
  29. how can nutritional deficiencies affect wound healing?
    • Vit C and protein deficiencies can 
    • - prevent formation of collagen fibers
    • - decreases supply of amino acids for tissue repair
  30. how can inadequate blood supply affect wound healing
    • - decreases supply of nutrients/ oxygen to injured area
    • - decreases removal of exudative debris
    • - inhibits inflammation response
  31. how can corticosteriod affect would healing
    • - depresses the formation of granulation tissue 
    • - inhibits wound contraction
  32. how can infection affect would healing
    increases inflammatory reponse and tissue destruction
  33. how can mechanical friction on wounds affect its healing?
    • - destroys granulation tissue
    • - prevents apposition of wound edges
  34. how can advanced age affect wound healing?
    • - slows the formation of collagen by fibroblasts
    • - impaired circulation
  35. how can obesity affect wound healing
    - decreases blood supply to fatty tissue
  36. how can poor general health affect would healing
    - generalized absense of factors necessary to promote wound healing
  37. treatment to enhance wound healing
    • - hypertonic oxygen
    • - nutrition
    • - debridment 
    • - prevent/treat infections
    • - control diseases like diabetes
    • - enhance circulation
  38. types of abnormal would healing
    • - keloid
    • - dehiscence 
    • - evisceration 
    • - contracture
  39. Dehiscence
    • a type of abnormal wound healing
    • - wound opens up again which leads to healing via secondary intention rather than primary intention which is not ideal
  40. evisceration
    • a type of abnormal wound healing 
    • - its where the wound opens up in the abdominal area and guts fall out
    • - usually in obese pts or pts with infections
  41. contracture
    • a type of abnormal wound healing
    • - adhesion formation when the wound contracts, the scar tissue wont stretch anymore and can limit the movement of that area

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