Term
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Definition
| -break or loss of cellular and anatomic continuity |
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Term
| What is wound healing influenced by? |
|
Definition
-host factors
-wound characteristics
-other external factors |
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|
Term
| What are the 4 stages of wound healing? |
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Definition
1. Inflammation
2. Debridement
3. Repair
4. MAturation |
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Term
| What are the goals of inflammation (stage I)? |
|
Definition
-eliminate microorganisms
-meutralize irritants
-promote removal of dead/dying tissue |
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Term
| Degree of inflammation is (directly/indirectly) proportional to degree of insult. |
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Definition
|
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Term
| How long dues the inflammatory phase of healing last? |
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Definition
|
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Term
| What are the 4 primary charactristics of the inflammatory phase of healing? |
|
Definition
-inc vascular permeability
-chemotaxis of circulatory cells
-release of cytokines/growth factors
-cell activation (macrophages, neutrophils, lymphocytes, fibroblasts) |
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|
Term
| What happens immediately during the inflammatory phase of healing? |
|
Definition
-defect enlarges (due to muscle pull)
-hemorrrhage fills he wound: cleanses and provides cells fro debridement |
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Term
| What happens after the initial response of the inflammatory phase of healing? Why does this occur? |
|
Definition
-small blood vessels constrict
-limits hemorrhage |
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Term
| What mediates the constriction of small blood vessels during the inflammatory phase of healing? |
|
Definition
| -catecholamines, serotonin, bradykinin, histamine |
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|
Term
| After vessel constriciton, what happens during the inflammatory pahse of healing? Why does this occur? |
|
Definition
-thrombus formation
-provides hemostasis, localizes inflammaiton, glues wound edges together, acts as a scaffold for cell migration |
|
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Term
|
Definition
| -leukocytes escape through endothelial gaps to initiate the debridement phase |
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Term
| What process initiates phase II of the healing process? |
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Definition
|
|
Term
| What occurs during debridement stage of healing? |
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Definition
|
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Term
| What are the key cells of the debridement stage of wound healing? |
|
Definition
| -neutrophils, monocytes, platelets, lymphocytes |
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Term
| What cells are the first wave of defense during the debridement phase of wound healing? HOw quickly do they appear? What do they do? |
|
Definition
-neutrophils
-appear within 6 hours
-remove organisms and debris (phagocytosis) |
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|
Term
| What cells are the second wave of debridement phase of wound healing? What do they do? |
|
Definition
-monocytes that develop into macrophages within 12-48 hours
-secrete collagenase to remove debris/bacteria and encourages tissue formation and remodeling |
|
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Term
| What do platellets do during the debridement phase of wound healing? |
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Definition
| -produce platelet-derved growth factors to recruit neutorphils/ monocytes |
|
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Term
| What do lymphocytes do with debridement during wound healing? When do they arrive? |
|
Definition
-associated with inflammation secondary foreign antigens/ infection
-arrive with macrophages |
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|
Term
| When does the third stage of wound healing begin? |
|
Definition
|
|
Term
| What are the three processes of the repair stage of wound healing? |
|
Definition
-fibroblast proliferation
-capillary infiltration
-epithelial proliferation and migration |
|
|
Term
| From where do fibroblasts originate? |
|
Definition
|
|
Term
| Whet do fibroblasts do during the third stage of healing? How do they get to the wound? |
|
Definition
-synthesize and deposit collagen, elastin, and proteoglycans
-migrate in the fibrin clot |
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|
Term
| How do capillaries get to the wound during the third stage of woun helaing? From where do they originate? |
|
Definition
-follow fibroblasts via angiogenesis
-originate from existing blood vessels |
|
|
Term
| What causes the granular/cobble stone appearance of granulation tissue? |
|
Definition
|
|
Term
| HOw soon after injury does granulation tissue develop? |
|
Definition
|
|
Term
| What are the functions of granulation tissue? |
|
Definition
-fills defects
-barrier to infection
-surface epithelial migration
-sourc of fibroblasts for wound contraction |
|
|
Term
| How is collagen synthesized? How long does it take? |
|
Definition
|
|
Term
| What type of collagen initially occurs during wound healing? How does it change? |
|
Definition
-initially type III
-then re-orients into horizontal type I |
|
|
Term
| What is the purpose of collagen in wound healing? |
|
Definition
|
|
Term
| When after tissue granulation does epitheliaziation occur? |
|
Definition
| -after a healty granulation bed is completed |
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|
Term
| What is contact inhibition? |
|
Definition
| -the point at which epithelial cells touch from opposing sides of the wound and thus show that epitheliazation is finished |
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Term
| What is the purpose of wound contraction during wound healing? |
|
Definition
-reduces the size of the wound: via fibroblasts, reorganizing collagen, myofibroblast contraction
-simultaneous with epitheliazation |
|
|
Term
| In which 3 instances will wound contraction cease during wound healing? |
|
Definition
-stops when edges meet (contact inhibition)
-when tension is excessive
-when myofibroblasts are inadequate |
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Term
| When does stage IV: maturation of the wound healing process occur? |
|
Definition
| -when collagen has been adequately deposited in wound |
|
|
Term
| What occurs during the maturation stage of wound healing? |
|
Definition
| -collagen fibers remodel: alteration in orientation, inc cross-linking, type I collagen predominates |
|
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Term
| What are the 3 major factors that optimize wound healing? Purposes? |
|
Definition
-bandages: moist environment and protection from infection
-Vitamin A: to reverse effects of corticosteroids
-Oxygen |
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Term
| What are the two major factors that delay wound healing? |
|
Definition
-systemic disease
-obesity |
|
|
Term
| What are some examples of systemic diseases that delay wound healing? |
|
Definition
-malnourishment
-hypoproteinemia
-hepatic dz (clotting factor deficiency)
-hyperadrenocorticism
-uremia
-diabetes |
|
|
Term
| What are some feline specific factors that delay wound healing? |
|
Definition
|
|
Term
| What are some issues other than disease that can delay wound healing? |
|
Definition
-local ischemia
-tension
-dad space
-seroma
-radiation therapy
-foreign bodies |
|
|
Term
| What are some drugs that can delay wound healing? |
|
Definition
-corticosteroids
-chemotherapy: alter protein synthesis
-aspirin: delays clotting |
|
|
Term
| At an anti-inflammatory dose, hose do corticosteroids delay wound healing? What about at an immunosuppressive dose? |
|
Definition
-causes suppression of neovascularization and fibroplasia
-cause progressive atrophy of collagen, loss of normal cross-links |
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