HEALING OF OPEN AND APPROXIMATED WOUNDS
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The document summarizes wound healing and skin grafting. It describes the process of healing for open and approximated wounds, including hemostasis, inflammation, granulation tissue formation, wound retraction, and tissue remodeling. It also discusses scar formation and maturation. Skin grafting involves transplanting skin to treat extensive wounds, burns, or skin loss, and the grafted skin undergoes healing after transplantation.
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HEALING OF OPEN AND APPROXIMATED WOUNDS
- 1. HEALING OF OPEN AND APPROXIMATED WOUND PRESENTED BY Aheed Khan Roll number-8
- 2. The Skin
- 3. Open wounds are:- 1. Puncture wounds 2. Abrasions 3. Friction burns 4. Lacerations 5. Bites
- 4. Process of Healing 1. Hemostasis and inflammation • recruitment of growth factors for regeneration and WBCs - fighting off potential infection • The stem cells proliferate to replace the damaged tissue
- 6. Granulation tissue • Granulation tissue-numerous blood vessels, edema, loose extracellular matrix containing occasional inflammatory cells. • The extent of angiogenesis and fibroblast proliferation -the extent of injury • If the wound is clean-the granulation tissue is less, but if its dirty and large- greater amount of granulation tissue is formed.
- 7. Primary Secondary
- 9. Wound retraction 1. Wound contractions -in union by secondary intention - the injury and the granulation tissue formed was large. 2. Myofibroblast start to develop at the edge of the wound which then function as smooth muscle cells causing wound contraction
- 10. Primary Secondary
- 11. Tissue remodeling • replacement of granulation tissue by normal extracellular matrix. • help of various chemicals secreted by macrophages such as metalloproteinases, disintegrins and gelatinases. • Subsequently the rate of degradation subsides and collagen accumulation starts to regain tensile strength.
- 12. Role of macrophages in wound healing PDGF, TGF-β, IL-1 MMPs, TNF, TGF VEGF,PDGF Phagocytosis, collegenase Nitric Acid Removal of debris angiogenesis Tissue Remodelling Antimicrobial activity Chemotaxis & fibroblast proliferation
- 13. in toto
- 14. Treatment objectives • Stop bleeding • Cleaning of the wound • Surgical debridement • Radiological examination
- 15. Approximated wounds are:- 1. Surgical wounds 2. Neat cuts from sharp objects
- 16. Healing of an approximated wound • An approximated wound heals by primary intention • Less granulation tissue • Less inflammation • Fast recovery with no or minimal infection
- 18. Scar formation • Occurs when injury is deeper to superficial dermis • Maturation phase--> disorganization of collagen
- 19. Scar maturation • Remodelling takes place over 6-12 months • Immature scars mature over an year
- 20. Skin grafting • surgery involving the transplantation of skin • used to treat: 1. Extensive wounding or trauma 2. Burns 3. Areas of extensive skin loss
Editor's Notes
- Egpyodermagangrenosum
- Postoperative Pyoderma Gangrenosum Developing After Throidectomy Authors: Tamer Koldas, MD, Hulya Aydın, MD, Cengiz Dibekoglu, MD, Bekir Aybey, MD, Tarik Terzioglu, MD treatment and healing after 4 months