Wound Care - conceptual physiology
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73 Terms
What are the four primary functions of the epidermis?
Acts as a barrier against microorganisms and toxic substances; prevents water loss; repels water; serves as the first line of defense against environmental antigens.
Why is the epidermis considered the body's first line of defense?
It protects against microorganisms
How does the dermis support the epidermis?
It provides structural support
How do the epidermis
dermis
Compare the epidermis and dermis.
The epidermis is an avascular epithelial barrier
Compare the dermis and hypodermis.
The dermis contains connective tissue
Why is the dermis highly vascularized?
To supply oxygen
Why are sebaceous glands important for skin integrity?
They secrete sebum that lubricates the skin and hair.
Why are sweat glands important for homeostasis?
They assist with thermoregulation by producing sweat.
How does adipose tissue protect the body?
It cushions underlying structures
Why is the hypodermis important in wound healing?
It contains blood vessels and lymphatics that help support healing while cushioning underlying tissues.
How do blood vessels contribute to wound healing?
They deliver oxygen
How do lymphatic vessels contribute to healing?
They remove excess interstitial fluid and participate in immune defense.
How do fibroblasts contribute to wound healing?
They synthesize collagen and extracellular matrix during tissue repair.
Why is collagen essential during healing?
It provides structural support and tensile strength to the healing wound.
How do macrophages contribute to healing?
They remove bacteria and dead tissue while coordinating tissue repair.
How do neutrophils contribute to healing?
They are early inflammatory cells that destroy microorganisms.
Why are growth factors released during hemostasis?
They initiate and regulate the wound-healing cascade.
What is the purpose of fibrin clot formation?
To stop bleeding and create a temporary scaffold for healing.
What is the overall purpose of normal wound healing?
To restore tissue integrity by progressing through the four healing phases in an orderly sequence.
What defines normal wound healing?
Orderly progression through hemostasis
What defines abnormal wound healing?
Failure to progress normally through the healing phases because of an underlying defect.
How do acute and chronic wounds differ?
Acute wounds heal normally after surgery or trauma
Why are chronic wounds described as recalcitrant?
Because they are persistent
What patient factors discussed in the lecture can impair healing?
Age
Why does diabetes contribute to delayed wound healing?
It is an underlying condition associated with impaired healing.
Why does vascular disease delay wound healing?
Reduced circulation limits delivery of oxygen and nutrients needed for tissue repair.
How does smoking impair wound healing?
Smoking is a modifiable risk factor associated with delayed tissue repair.
How does poor nutrition impair healing?
It reduces the nutrients required for collagen synthesis and tissue repair.
How does immobility contribute to wound formation?
Prolonged pressure increases tissue injury risk.
What are the four phases of wound healing?
Hemostasis
What is the primary goal of the hemostasis phase?
Stop bleeding and initiate the wound-healing cascade.
What major events occur during hemostasis?
Coagulation pathways activate
Approximately when does the hemostasis phase occur?
Immediately after injury and approximately the first 1–2 days.
What is the primary goal of the inflammatory phase?
Control infection and establish a clean wound bed.
What major events occur during the inflammatory phase?
Neutrophils and macrophages remove bacteria and debris while edema
When does the inflammatory phase typically peak?
Approximately 3–5 days after injury.
When is the inflammatory phase generally complete?
Around day 10.
What clinical findings are expected during the inflammatory phase?
Edema
Why are edema and warmth expected during inflammation?
They reflect the normal inflammatory response during tissue repair.
What is the primary goal of the proliferative phase?
Build new tissue and close the wound.
What major events occur during the proliferative phase?
Angiogenesis
What is angiogenesis?
Formation of new blood vessels to supply healing tissue.
Why is angiogenesis necessary?
Healing tissue requires an adequate blood supply for oxygen and nutrient delivery.
What is epithelialization?
Migration and proliferation of epithelial cells to restore the skin surface.
Why is epithelialization important?
It restores the protective epidermal barrier.
What is wound contraction?
Reduction in wound size through contraction of surrounding tissues.
Why is wound contraction beneficial?
It decreases the amount of tissue that must be repaired.
What is matrix deposition?
Formation of extracellular matrix that supports new tissue growth.
Why is collagen synthesized during the proliferative phase?
To provide structural support for newly forming tissue.
What is the primary goal of the maturation (remodeling) phase?
Reorganize collagen and maximize scar tensile strength.
Approximately when does the maturation phase begin?
Around day 21 after injury.
How long can the maturation phase continue?
Beyond one year.
Why does collagen remodel during maturation?
To improve the organization and strength of scar tissue.
Why does healed skin never regain its original strength?
Scar tissue remodels but does not completely restore normal tissue properties.
Compare hemostasis and the inflammatory phase.
Hemostasis stops bleeding through clot formation
Compare the inflammatory and proliferative phases.
Inflammation cleans the wound
Compare the proliferative and maturation phases.
Proliferation creates new tissue; maturation strengthens and remodels the scar.
Which phase is primarily responsible for stopping bleeding?
Hemostasis.
Which phase is primarily responsible for cleaning the wound?
Inflammatory phase.
Which phase is primarily responsible for forming new tissue?
Proliferative phase.
Which phase is primarily responsible for increasing scar strength?
Maturation (remodeling).
Which wound-healing phase lasts the longest?
Maturation (remodeling).
How do sutures
staples
Compare a skin graft and a skin flap.
A skin graft is transferred without maintaining its original blood supply
When is a musculocutaneous flap useful?
When additional tissue bulk and blood supply are required.
What advantage does a microvascular free flap provide?
It allows transfer of tissue from distant locations with microsurgical reconnection of blood vessels.
Why is adequate blood supply critical throughout wound healing?
Healing depends on continuous delivery of oxygen
Why is protein emphasized during wound healing?
Protein provides the building blocks required for collagen synthesis and tissue repair.
What protein intake is recommended in the lecture for wound healing?
Approximately 1.25–1.5 g/kg/day
Why are carbohydrates necessary during wound healing?
They provide the primary energy source and glucose needed for collagen synthesis.
How can a clinician recognize that a wound is progressing through normal healing?
The wound progresses through the healing phases in the expected sequence with findings appropriate for each phase.
What is the overall objective of wound management according to the concepts in this lecture?
Promote orderly progression through the normal wound-healing phases while minimizing factors that delay healing.