Ag 421 wound healing
Terms
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- What are the 4 phases of wound healing?
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1. Inflammatory
2. Debridement
3. Repair
4. Maturation - A disruption of the normal integrity of the skin due to a purposeful (surgery) or incidental insult (trauma)
- wound
- The process of healing occurs when?
- immediatley after injury
- When does the inflammatory phase occur?
- ~0-6 hours post injury
- What occurs in the inflammatory phase?
- hemorrhage occurs, vasoconstriction occurs, vasodilation occurs, clot forms, scab forms
- What is the purpose of clotting?
- stabilizes wound edges, fibrin in clot provides limited wound strength
- What is the purpose of a scab?
- protects wound, prevents further hemorrhage, allows healing to progress under its surface
- When does the debridement phase occur?
- ~6 hours to 5 days after injury
- What occurs in the debridement phase?
- Neutrophils and monocytes migrate into wound
- Why do neutrophils and monocytes migrate into wound?
- To remove necrotic tissue bacteria and foreign material.
- When does the repair phase occur?
- ~3-5 days after the wound occurs
- What occurs in the repair phase?
- New tissue formed by fibroblasts and capillaries, granulation tissue, formation of new epithelium, wound contraction
- When does the maturation phase occur?
- ~17-28 days - 1-2 years (depending on wound)
- What occurs in the maturation phase?
- remodeling of collagen fibers
- What factors affect wound healing?
- host factors, wound factors, external factors.
- What are some host factors?
- Age, malnourishment, hypoproteinemia, hyperadrenocorticism, diabetes mellitus, clotting factors deficit
- What are some wound factors?
- Foreign material, contaminated tissue, bacterial toxins, damage to blood supply, movement in healing wound
- What are some external factors?
- Corticosteriods, anti-inflammatory drugs, chemo drugs, radiation
- Removal of contaminated, devitalized or necrotic tissue and all foreign material from the wound
- wound debridement
- The removal of debris and loose particles which helps decreases bacterial numbers.
- Wound lavage
- What are the type of wound closures?
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Primary wound closure
Delayed primary wound closure
Secondary closure
Second Intention Healing - What is primary wound closure?
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Suturing or grafting
Indicated in fresh, clean, sharply incised wounds seen within 6-8hrs of injury - What is delayed primary wound closure?
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1-3 days after injury
B4 granulation tissue appears - What is secondary closure?
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After 3-4 days
After granulation occurs - What is second intention healing?
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Heals w/out surgical closure
Heals by contraction & epithelialization - Incised wounds heal with?
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minimal tissue damage
minimal dead tissue
minimal contamination - Factors in wound management decision making?
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1. Time since injury (most important factor)
2. Degree of wound contamination
3. Degree of tissue trauma
4. Thoroughness of initial debridement
5. Blood supply of wound
6. Animals physical status
7. Wound tension and possibility of closure
8. Location of wound