Guidelines for Wound Assessment (module 2)

What is the supportive rationale for the use of moist wound healing techniques? How does a moist environment better wound closure?

1. Supporting cell proliferation and migration. 2. Allowing adequate oxygen supply. 3. Decreasing pain and inflammation. 4. Formation of soft scab and prevention of hard scab. 5. Promoting formation of new blood vessels. 6. Reducing the risk of infection by deterring growth of bacteria. 7. Better support for collagen synthesis. 8. Minimize wound debridement. 9. Reduction of painful dressing changes. 10. Maintaining correct pH. supports the current of injury! trap growth factors and enzymes to help promote wound healing promotes autolytic debridement (liquifying necrotic tissue)

What is granulation tissue? What does granulation tissue look like?

Granulation tissue is a latticework of vascularized connective tissue primarily made of:FibroblastsEndothelial cellsInflammatory cellsGround substance Granulation tissue looks like:Beefy red: Abundance of blood vesselsPink: Around wound margin due to new epitheliumMoist: Due to Vascularity

What is hyper granulation tissue? What are the causes of hyper granulation tissue?

Hyper granulation tissue is characterized by an elevated beefy red appearance due to excess of granulation tissue that protrudes of above skin with causes including: Excessive moisture Infection Improper dressing Underlying pathology

What role do fibroblasts play in wound healing? During which stage of healing are fibroblasts the most active?

Most active in proliferation phase with roles including: Wound contraction through myofibroblasts.Manufacturing collagen to provide framework for tissue repair and closure of the wound.Formation of ground substance for organization of tissues and cell migration.

Describe the major processes that occur during the remodeling phase. How long does the remodeling phase last?

The body attempts to normalize the scar tissue and finds a balance between collagen formation and collagen lysis. Type 3 collagen is converted to type 1 collagen, which is stronger. This phase lasts anywhere from 21 days to 2 years.

What is the current of injury? How does the current of injury support wound closure?

The current of injury is the electric gradient from the center of the body to an injured site of the body. The current of injury helps to attract cells that are needed for the repair process of a wound.

Outline key events that occur during the inflammatory phase of wound healing.

Vasoconstriction Vasodilation Platelet Activation Formation of Platelet Plug Clotting Cascade Activation Inflammation Initiation Migration of White Blood Cells Chemotaxis Removal of Debris Release of Cytokines and Growth Factors Temporary Fibrin Matrix Formation

What types of growth factors help transition the wound from the inflammatory phase to the proliferative phase? Give examples.

*PDGF - Platelet Derived Growth factor*Promoting angiogenesisStimulating fibroblasts. *EGF - Epidermal Growth Factor*Stimulating keratinocytesFormation of granulation tissue *TGF-B - Transforming Growth Factor-Beta*Promoting AngiogensisStimulating fibroblastsMyofibroblast differentiation *IGF - Insulin-Like Growth Factor*Proliferation of fibroblasts and myofibroblasts.

What role do macrophages play during initial stages of wound healing?

*Phagocytosis:* Engulfing/digesting debris and pathogens. *Cytokine release:* Attracting immune cells and regulating inflammation. *Stimulate Angiogenesis:* Release of growth factors and MMPs. *Cell recruitment:* Fibroblasts and endothelial cells.

What are some of the treatment interventions that can be used to address hypergranulation?

Some treatment interventions used to address hypergranulation include compression, silver nitrate, and surgical excision.