Define a wound
A wound is a break in the integument or underlying structures that results from physical, mechanical or thermal damage or develops as a result of an underlying disorder.
List the functions of the skin
Functions of skin includes:
a) Protection – An anatomical barrier from pathogens and damage between the internal and external environment in bodily defense. b) Sensation – Contains a variety of nerve endings that jump to heat and cold, touch, pressure, vibration, and tissue injury. c) Thermoregulation – Eccrine glands and dilated blood vessels aid heat loss, while constricted vessels greatly reduce cutaneous blood flow and conserve heat. Erector pill muscles in mammals adjust the angle of hair shafts to change the degree of insulation provided by hair or fur. d) Control of evaporation – The skin provides a relatively dry and semi-impermeable barrier to fluid loss. e) Absorption – Oxygen, nitrogen and carbon dioxide can diffuse into the epidermis in small amounts. f) Water resistance – Act as a water resistant barrier so essential nutrients aren’t washed out of the body.
The skin has three (3) layers, name these three layers and give a brief description of each layer.
1) Epidermis – Provides waterproofing and serves as a barrier to infection, also helps the skin regulate body temperature. 2) Dermis – Serves as a location for the appendages of skin. It provides tensile strength and elasticity to the skin through an extracellular matrix composed of collagen fibrils, microfibrils and elastic fibers, embedded in proteoglycans. 3) Hypodermis – Attach skin to underlying bone and muscle as well as supplying it with blood vessels and nerves. It consists of loose connective tissue and elastin.
Name phases of wound healing and give an explanation of what occurs in each phase.
I. Inflammatory Phase - Immediate to 2-5 days; Hemostasis (Vasoconstriction, Platelet aggregation, Thromboplastin makes clot); Inflammation (Vasodilation, Phagocytosis )
II. Proliferative Phase - 2 days to 3 weeks; Granulation (Fibroblasts lay bed of collagen, Fills defect and produces new capillaries); Contraction (Wound edges pull together to reduce defect); Epithelialization (Crosses moist surface, Cell travel about 3 cm from point of origin in all directions)
III. Remodeling Phase - 3 weeks to 2 years; new collagen forms which increases tensile strength to wounds; Scar tissue is only 80 percent as strong as original tissue.
Many wounds that are in the inflammatory phase of wound healing are often mistaken for being infected. Why is this so? How can we determine whether the wound is infected of in the infected or in the inflammatory phase?
Both type of wounds look similar in appearance. The inflammatory phase is a vital stage in the wound-healing process, without which healing will not progress. Inflammation is apparent in all wounds at some point. However, its presence may also signal the onset of infection, an allergic reaction or dermatitis. When assessing infected wounds, some groups of people will not produce the classical symptoms associated with wound infection. In this instance we should look for additional signs. For example, a person with diabetes may also fail to produce the classical symptoms of infection owing to reduced neutrophil activity.
What is your understanding of granulation and epithelialisation?
Granulation is a part of the healing process in which lumpy, pink tissue containing new connective tissue and capillaries forms around the edges of a wound. Granulation of a wound is normal and desirable.
Epithelialisation is the natural act of healing dermal and epidermal tissue in which epithelium grows over a wound. Epithelium is a membranous tissue made up of one or more layers of cells that contains very little intercellular substance.
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