Types of Wound Healing
Primary Intention Healing |
Healing by a non-infected and uninterrupted surgical incision |
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Typically held by sutures or other physical support |
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Not as much cell death or tissue loss, very predictable healing |
Second Intention Healing |
Requires removal of necrotic tissue due to increased cell death |
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Much slower healing process, leads to scar tissue |
Wound Healing in short
Vascular Response |
hemostasis - Goal is to control bleeding |
Inflammatory Response |
Inflammation- Goal is to clean debris/bacteria and prevent infection |
Proliferative Phase |
granulation, epithelialization (the active growth phase). Goal is reconstruction/scar tissue formation |
Maturation Phase |
reconstructive phase- goal is to remodel |
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Factors Influencing Wound Healing
Diabetes |
Poor circulation which slows down the blood which makes it harder to deliver nutrients to wound. |
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Decreased production of new blood vessels growth and healing hormones |
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Glucose in blood and urine is energy source for bacteria (leads to infections) |
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Depression of the antioxidant system and humoral immunity (leads to infections) |
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Neuropathy. They cannot feel pain so they won't know if a wound is getting worse/infected. |
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Elevated glucose levels decrease the functioning of red blood cells carrying nutrients to the injured area and limit the effectiveness of white blood cells fighting infections. |
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The inflammation stage frequently lasts too long and the wound can become chronic. In chronic wounds, the balance between producing and degrading collagen is lost and the wounds don't heal. |
Nutrition, perfusion, immune status, infection, age |
Wound Environment |
wound type, size, location, type, depth |
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Wounds
Definition |
A wound is a break in the continuity of soft tissues |
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Caused by a chemical, physical or biological insult |
Types of Wounds |
Incised, lacerated, penetrated, perforating, punctured, gunshot, abrasion, avulsion, bite, ulcerating, granulating, septic/aseptic, closed |
Aseptic = clean wound
septic = infected wound
Macrophages
-Critical cells because they secrete AGF |
-Produce a host of cytokines and growth factors and act as chemoattractants to the other cells needed for tissue repair |
-Convert macromolecules to amino acid and sugars necessary for wound healing |
-Bring in contractual cells to encourage wound contraction |
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