Inflammation & Wound Healing Terms - Chapter 9 Study Guide

Complications of Wound Healing

- wound rupture

- keloid formation

- contractures

- stricture

- fistula

- adhesion

Wound Rupture - High Tension

excessive stress or pressure on a wound, increasing the risk of rupture (ex. coughing opening a wound in the abdomen)

Wound Rupture - Dehiscence

- previously closed wound edges open and rupture

- requires immediate wound protection (sterile gauze / dressing)

Wound Rupture - Evisceration

- internal tissues and organs protrude out from the open wound

- requires immediate wound protection (sterile gauze / dressing)

Keloid Formation

hyperplastic epithelialization leading to hypertrophic scar

Contractures

- inflexible shrinkage of a wound

- can limit mobility

Stricture

narrowing of an open area (esophageal stricture)

Fistula

abnormal connection between two structures (tracheoesophageal fistula)

Adhesion

abnormal bands of internal scar tissue that can limit mobility

Fever

- systemic response in acute inflammation

- increases WBC efficiency

Pyrogens

substances that cause fever

Treatment of Fevers

anti-prostaglandins (ex. tylenol, aspirin, motrin)

Dangerous Effects of Fever

denatures protein, brain damage, seizures

Reye's Syndrome

rare swelling of the brain resulting in liver damage

Do you give children asprin to reduce their fevers?

no; can lead to reye's syndrome

Wound Healing: Primary Intention

- no missing tissue

- clear wound edges

- simple epithelialization

- found in surgical wounds & incisions

Wound Healing: Secondary Intention

- extensive tissue loss

- granulation and fibrotic tissue formation

- longer healing time with wound contraction to close the gap

- scar tissue formation

Wound Healing: Tertiary Intention

- missing large amounts of deep tissue

- contaminated wound

- prominent scarring with skin graft often required

- cleaned and left open to heal (temporary packing with sterile gauze)

4 Phases of Wound Healing

- hemostasis

- inflammation

- cellular processes

- wound contraction and remodeling

Hemostasis

- body's natural process to stop bleeding

- exposed collagen at the injury site attracts platelets

- leading them to aggregate and form a platelet plug

Inflammation

- walls off injured area preventing spread of injury

- pus, redness, heat, swelling, etc.

Cellular Processes

- change of tissue appearance

- proliferation

- granulation tissue formation

- angiogenesis

- epithelialization

Wound Contraction and Remodeling

- wound has healed

- begins approximately 3 weeks after injury

5 Classic Signs of Inflammation

- rubor (redness)

- calor (heat)

- tumor (swelling)

- dolor (pain)

- function laesa (loss of function)

Factors Involved in Wound Healing

- nutrition

- oxygen

- circulation

- immune strength

- age

- obesity

- infection

- autoimmune diseases

- foreign bodies

- mechanical factors

Factors Involved in Wound Healing - Nutrition

need protein for positive nitrogen balance

Factors Involved in Wound Healing - Oxygen

facilitates collagen synthesis and WBC function

Factors Involved in Wound Healing - Circulation

delivers oxygen an nutrients to injured areas

Factors Involved in Wound Healing - Immune Strength

need a competent immune system to heal faster

Factors Involved in Wound Healing - Age

immune response decreases with age

Factors Involved in Wound Healing - Obesity

reduces circulation, prolongs inflammatory phase, increases pressure on wounds

Factors Involved in Wound Healing - Infection

prolongs healing process since inflammation is perpetuated

Factors Involved in Wound Healing - Autoimmune Diseases

diabetes, rheumatoid arthritis, systemic lupus erythematosus

Factors Involved in Wound Healing - Foreign Bodies

debris in wound

Factors Involved in Wound Healing - Mechanical Factors

- localized pressure on wound

- torsion

Histamines - Produced By

mast cells, basophils, and platelets

Histamine - Systemic Effects

- arteriolar vasodilation

- large artery vasoconstriction

- increased permeability of venules

Histamine - Signs and Symptoms

- sneezing

- runny nose

- pharyngeal irritation

Prostaglandins - Systemic Effects

- fever

- pain

- vasodilation

- muscle spasms

- edema

Prostaglandin-1 (COX-1)

- helpful PGs

- promotes gastric mucus production and platelet aggregation to protect

Prostaglandin-2 (COX-2)

- harmful PGs

- contributes to pain and inflammation

What does it mean when a patient has elevated WBCs?

Patient has an infection or experiencing inflammation

When there is vascular inflammation, which component makes the blood vessels dilate & become more permeable?

Histamine (inflammatory mediator)