Surgery 1: Wound Healing and Wound Care

A comprehensive set of 150 flashcards covering the phases of wound healing, management of wounds, and associated pathologies.

What initiates wound healing?

Exposure of intravascular elements to extravascular collagen and subendothelial collagen.

What occurs during the hemostasis phase?

Formation of a platelet plug and fibrin clot.

What is the most potent hemostatic barrier for wound injuries?

Fibrin clot.

What cells are primary responders in the inflammation phase?

Polymorphonuclear cells (PMN).

What is the role of macrophages in wound healing?

They trigger the release of growth factors necessary for tissue repair.

What factors regulate the proliferation phase of wound healing?

Platelet-derived growth factors (PDGF), TGF-β, VEGF, IGF, EGF.

What types of collagen are produced during matrix synthesis?

Collagen I and II.

Where is Type I collagen found?

Bone, skin, dentin, cornea, blood vessels, fibrocartilage, and tendon.

Where is Type II collagen found?

Cartilaginous tissues.

Which vitamin is crucial for collagen synthesis?

Vitamin C.

What trace metal is important for collagen synthesis?

Zinc.

What is the impact of infection on collagen formation?

Infection increases pH and impairs collagen bonds.

How is collagen strength enhanced?

Through hydroxylation during cross-linking.

What is a key feature of the maturation and remodeling phase?

Increased tensile strength and collagen cross-linking.

Can healed tissue return to 100% strength?

No, it varies by tissue type.

What is a scar?

Connective tissue formed after injury.

What is the importance of re-epithelialization?

It restores skin integrity and supports function.

What are growth factors?

Polypeptides that stimulate cellular migration, proliferation, and function.

What triggers wound contraction?

Myofibroblasts shortening the scar area.

What defines primary intention in wound healing?

Healing facilitated by human intervention, like sutures.

What is Ehlers-Danlos syndrome?

A connective tissue disorder caused by defects in collagen formation.

What are common manifestations of Marfan syndrome?

Tall stature, aortic aneurysm, arachnodactyly.

What characterizes osteogenesis imperfecta?

Defective type I collagen leading to brittle bones.

What is the main issue with epidermolysis bullosa?

Tissue adhesion impairment leads to blistering.

What does acrodermatitis enteropathica affect?

Zinc absorption leading to impaired wound healing.

What are chronic wounds?

Wounds that do not go through the normal healing process.

What distinguishes venous stasis ulcers from arterial insufficiency?

Temperature differences: venous stasis is warm; arterial insufficiency is cold.

What are hypertrophic scars?

Raised scars that do not extend beyond the injury boundary.

What defines keloid scars?

Scarring that extends beyond the original wound.

What is peritoneal scarring?

Intra-abdominal adhesions following injury or surgery.

What is the importance of managing acute wounds?

To prevent complications such as infection and impaired healing.

What type of dressings are used in wound care?

Absorbent, non-adherent, occlusive, and medicated dressings.

What are the characteristics of good sutures?

High tensile strength, sterility, and pliability.

What is the difference between absorbable and non-absorbable sutures?

Absorbable sutures are broken down by the body; non-absorbable remain permanently.

What causes scars to lack the strength of uninjured tissue?

The mechanical integrity of scars is lower than the original tissue.

What is the role of Platelet-derived growth factors (PDGF)?

They are crucial for cell recruitment and angiogenesis.

Define dehiscence in wound healing.

Splitting open of a wound.

What is a fistula?

An abnormal passage between two hollow or tubular organs.

What happens during hypertrophic scarring?

Excess collagen production due to dysfunction in collagen regulation.

How does oxygen supply affect wound healing?

Adequate oxygen is essential for collagen cross-linking and strength.

What is a fundamental requirement for a successful healing process in the gastrointestinal tract?

Tension-free anastomosis with good blood supply.

What tissues heal well due to their vascularity?

Skin and muscle tissues.

How does the presence of serosa influence healing in the gastrointestinal tract?

It provides a watertight seal and promotes healing.

What kind of cartilage is typically avascular?

Hyaline cartilage.

Where do tendons get their regenerative capacity?

From tenocytes present in the tendon.

What is tendon wound healing dependent on?

Hematoma formation, organization, and ECM laying down.

Name a key factor in healing cartilage.

Depth of injury influences healing.

How does the lack of blood supply affect cartilage healing?

It results in poor healing and permanent defects.

What common injuries affect tendons?

Laceration, rupture, and contusion.

What condition results from negative pressure causing wounds?

Pressure ulcers (decubitus ulcers).

What nutritional deficiencies delay wound healing?

Deficiencies in vitamins, trace metals, and overall nutrition.

What surgical procedures can lead to peritoneal scarring?

Prior surgeries that cause tissue injury.

What is the difference between monofilament and multifilament sutures?

Monofilament is a single strand; multifilament consists of multiple strands.

What is an important procedure to perform when managing acute wounds?

High-pressure wound irrigation.

What is the function of ICAM in wound healing?

Facilitates cell adhesion and migration.

What are lactic acids' role during wound healing?

Lactic acid builds up during the inflammatory phase and aids fibroblast proliferation.

What is the function of growth factors like TGF-β in wound healing?

They stimulate matrix synthesis and cellular activities.

How does collagen I contribute to wound healing?

It forms a scaffold for cells to migrate and proliferate.

In what phase do fibroblasts become predominant?

During the proliferation phase.

How is the tensile strength of a tendon after injury?

Can return up to 95% of its original strength.

What is the result of collagen break down in the first week of healing?

Decreased strength due to collagenolysis.

What is chronic inflammatory wound healing?

A process that lacks progression through normal healing phases.

What major challenge do diabetic wounds present?

Chronic ischemia leading to poor healing.

What composes a scar tissue matrix after maturation?

Collagen, glycosaminoglycans, and fibronectin.

What physiological compromise supersedes effective healing in chronic wounds?”,

Tissue hypoxia, increased inflammation, or altered blood supply.

How critical is the role of nutrients in collagen synthesis?

Sufficient amino acids and cofactors are necessary for reports of collagen synthesis.

Describe the histological changes during the maturation phase.

Collagen reorganization, cross-linking, and increased tensile strength.

What is a key clinical sign of successful wound healing?

Formation of granulation tissue.

What laboratory test might reveal deficiencies affecting wound healing?

Complete blood count (CBC) can reveal anemia or leukocytosis.

What condition is critical in preventing hypertrophic and keloid scars?

Proper wound care and timely removal of sutures.

How long can it take for collagen deposition to plateau?

It can take several weeks, but tensile strength may continue to improve.

Explain the role of matrix metalloproteinases in healing.

They help regulate collagen deposition and remodeling.

When should sutures generally be removed from the face?

4 to 5 days post-surgery.

What is a common dressing material used for post-operative wounds?

Hydrocolloid or hydrogel dressings.

Why may skin grafts be necessary?

To replace lost tissue and expedite epithelial barrier formation.

What corrective measures should be taken in high-tension wounds?

Rotation of musculocutaneous flaps may be needed.

How can chronic inflammation manifest in wounds?”,

As swelling, erythema, and the presence of necrotic tissue.

What is significant about the presence of polymorphonuclear cells in wounds?

They signify the acute phase of inflammation.

What role do cytokines play during wound healing?

They regulate the inflammatory and proliferative phases of wound healing.

How are sutures affected by external infections?

They can harbor organisms and lead to postoperative infections.

What does the term debridement refer to in wound management?

The removal of dead or infected tissue.

What is a common consequence of excessive collagen deposition?

Formation of keloids.

How does granulation tissue contribute to healing?

It provides a scaffold that supports cell migration and proliferation.

What is the significance of the basement membrane during skin healing?

It serves as a critical interface for cell migration.

What dietary considerations are important for wound healing?

Adequate intake of protein, vitamins, and minerals is crucial.

How does the serosal layer contribute to GI wound healing?

It facilitates better blood supply and creates a watertight seal.

How does excessive moisture impact wound healing?

It can lead to maceration and delayed healing.

What defines a superficial layer of injury versus a deep one in wound healing?

Superficial injuries primarily affect the epidermis, whereas deep injuries involve the dermis and underlying tissues.

What factors influence the healing of exposed bone?

Blood supply and local infection control are significant.

How does fat necrosis affect wound healing?

It can lead to delayed healing due to local inflammation.

What pattern of collagen deposition indicates effective healing?

A randomized, but organized pattern of collagen fibers.

What is the function of PDGF in tendon healing?

It promotes fibroblast migration and proliferation.

What role do growth factors serve in tissues' wound healing processes?

They act as signaling molecules to coordinate healing activities.

How does tension influence suturing technique selection?

Increased tension necessitates stronger suturing techniques and materials.

What is an effective strategy for managing wounds under high tension?

Using tension-reduction techniques such as flap rotation.

What is a common complication in poorly managed wounds?

Infection can lead to chronicity and impaired healing.

What criteria guide the choice of suture material?

Tissue type, level of tension, and healing duration are key considerations.

What do suture characteristics like diameter and strength impact?

These factors affect the handling, knot security, and tissue acceptance post-surgery.

How does the surgical site location influence healing?

Areas with more movement may require different techniques for optimal healing.

What factor can indicate potential complications in surgical wounds?

The presence of necrotic tissue could indicate underlying infection.