Wound Healing Lecture Notes
Phases of Wound Healing
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Hemostasis
- Goal: Stop bleeding
- Mechanisms: Vasoconstriction, clotting cascade, platelet activation
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Inflammatory Stage
- Normal part of wound healing
- Allows neutrophils (first responders) to reach injury
- Process: Diapedesis (vasodilation of capillaries to make them leaky)
- Effects: Swelling, edema, pain
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Proliferation Phase
- Generating new skin cells
- Filling and covering the wound
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Maturation Phase
- Remodeling scar tissue
- Can take a year or more to strengthen scar tissue
Healing by Intention
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Primary Intention
- Edges well approximated
- Example: Surgical incision
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Secondary Intention
- Wound left open to heal by granulation, contraction, and epithelialization
- Heals from inside out
- Higher risk of infection, longer healing time
- Example: Pressure injury
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Tertiary Intention
- Delayed closure
- Allows for irrigation, debridement, and observation
- Closed surgically later when infection risk is lower
Complications and Barriers of Healing
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Dehiscence
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Evisceration
- Dehiscence with organ protrusion
- Emergency: Apply saline-moistened gauze, lower head of bed, notify provider
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Barriers
- Chronic illnesses: Diabetes mellitus (poor circulation, fluctuating blood glucose)
- Immunosuppression: Corticosteroid use
Drainage and Wound Appearance
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Types of Drainage
- Serous: Watery, clear to off-white
- Serosanguineous: Pink-tinged
- Sanguineous: Bright red, bloody
- Purulent: Thick, cloudy, foul-smelling (indicates infection)
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Wound Appearance
- Red: Healthy, good circulation
- Yellow: Needs cleaning
- Black: Needs debridement (removal of necrotic tissue)
Conclusion
- Importance of understanding wound healing phases
- Recognizing complications to provide appropriate care
- Monitoring drainage and wound appearance for effective treatment
Additional Notes:
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- Next topic: Diabetic foot care and wound care.
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