Question

Give an example of each of the four types of wound healing. Describe for the rationale for choosing each of these answers.

How long will it take a wound to heal?

please type answers

Answer 1

Answer :

WOUND : wound is a break in the integrity of the skin or tissue often which may be associated with disruption of the structure and function .

WOUND HEALING : wound healing is a complex process in which the skin and the tissue under it ,repair themselves after injury .

Stages :

1. Haemostasis phase .
2. Defensive / inflammatory phase .
3. Proliferative phase .
4. Maturation phase .

Types of wound healing :

• Healing by first intention ( wounds with opposed edges )
• Healing by secondary intention ( wound with seperated edges ).

HEALING BY PRIMARY INTENTION :

• Healing by primary intention occurs in wounds with dermal edges that are close together . Ex : scalpel incision .
• It has four stages :

- haemostasis stage : the action of platelet and cytokines forms a hematoma and causes vaso constriction and limiting blood loss at the affected area .

- inflammatory stage : a cellular inflammatory response acts to remove any cell debris and pathogens present .

- proliferative stage : cytokines released by the inflammatory cells drive the proliferation of the fibroblast and formation of grannulation tissue .

Angio genesis is promoted by the presence of the growth mediators ( VEGF) allowing for further maturation of the granulation tissue .the production of the collagen by fibroblast allows for closure of the wound after around a week .

- remodelling stage : devascularization of the region occurs and fibroblast undergo apoptosis .the end results of healing by primary intention is a complete return to function with minimal scarring and loss of skin appendages .

EXAMPLE FOR PRIMARY INTENTION :

any wound made by the scalpel will heal by primary intention ,surgeons can aid healing by ensuring adequate opposition of the wound edges - often by using surgical glue ,sutures or staples .

Rationale : close proximity of wound edges allows for ease of clot formation and prevent infection by forming scab ,and it will help in early wound healing .

HEALING BY SECONDARY INTENTION : it occurs when the sides of the wound are not apposed and so healing must occur from the bottom of the wound to upwards .

It is also occur in same four stages :

- haemostasis : a large fibrin mesh forms ,which fills the wound

- inflammatory stage : inflammatory response acts to remove any cell debris and pathogens present .

-proliferative stage : granulation tissue forms at the bottom of the wound .it is important stage as to epithelia can only proliferate and regenerate once granulation tissue fills the wound to the level of original epithelium .once granulation tissue reaches this level,the epithelium can completely cover the wound .

- remodelling stage : inflammatory response begins to restore and wound contraction can occur . Myo fibroblast are vital cells in secondary intention ,they are modified smooth muscle cells that contain actin and myosin act to contract the wound and decrease the space between the dermal edges .

EXAMPLE FOR SECONDARY INTENTION :

pressure ulcers

Rationale : pressure ulcers are the wounds which has long duration to heal ,it has a range from skin to bone damage

- pressure ulcers has the irregular edges because ,if the where occur that particular area may be damaged .

- wound healing process can be takes more time about weeks to months ,some times it cannot be healed ( Bed ridden cases )

HOW LONG IT TAKE WOUND TO HEAL :

• First 24 to 48 hours : spurts of epithelial cells from the edges migrate and grow along the cut margins .
• 3 rd ray : neutrophils replaced by macrophages . Granulation tissue progressively invades and proliferation continues .
• 5th day : incision or injury space is filled with granulation tissue ,collagen fibers are more abundant eidermis recovers its normal thickness .
• After the five days in to the wound healing process ,the tissue regrowth stage begins ,it typically lasts around three weeks from minor wounds and it is the time when the body repair broken blood vessels and replace damaged tissue with healthy new ones .