Open Injuries & Wounds

• Complications of wound healing

  • Hematoma
  • Seroma
  • Infection
  • Fistula
  • Dehiscence
  • Hypertrophic scars, keloids
• Phases of healing

  1. Haemostasis

  2. Inflammation

  3. Granulation/proliferation

  4. Remodelling/maturation
• Open injuries

  Injuries where skin is broken, exposing underlying tissues
• First Aid

  1. Control bleeding

  2. Wound cleaning

  3. Antisepsis

  4. Wound covering

  5. Immobilization

  6. Tetanus shot

  7. Pain management
• Types of open injuries

  • Lacerations
  • Incisions
  • Punctures
  • Avulsions (Tearing away of skin and tissue from the body)
  • Abrasions
  • Crushing
  • Gunshot wounds
• Prolonged wound healing causes

  • Diabetes mellitus
  • Vitamin C deficiency
  • Malnutrition
  • Long-term steroid therapy
  • Rheumatoid arthritis
  • Malignant diseases
• Healing of wounds

  1. Primary

  2. Delayed primary

  3. Secondary
• Primary healing typically occurs within hours of injury.
• Delayed primary healing is observed in contaminated wounds, involving phagocytosis by day 4 and subsequent granuloma formation.
• Secondary healing involves an inflammatory response to remove infection and necrotic tissue, followed by the formation of granulomatous tissue.
• Haemostasis aims to stop bleeding by inducing vasoconstriction and platelet aggregation, leading to blood clot formation that seals off the wound.
• Inflammation occurs, characterized by increased blood flow, redness, warmth, and swelling at the wound site. White blood cells migrate to clear debris and bacteria.
• Granulation/proliferation begins, where new tissue primarily consisting of granulation tissue composed of blood vessels, fibroblasts, and extracellular matrix forms.
• During the remodelling/maturation phase, collagen fibres reorganize, and the wound contracts as myofibroblasts exert tension on the surrounding tissue, reducing its size. Over time, the scar matures, becoming less noticeable and gaining strength, a process that can last for months to years.
• What are the types of open injuries?

  Lacerations, Incisions, Punctures, Avulsions, Abrasions, Crushing, Gunshot wounds
• Describe the primary phase of wound healing.

  It occurs within hours and involves stopping bleeding through vasoconstriction and platelet aggregation, forming a blood clot to seal off the wound.
• What is the purpose of the inflammation phase in wound healing?

  The body initiates an inflammatory response to increase blood flow to the wound site, leading to redness, warmth, and swelling. White blood cells migrate to clear debris, bacteria, and foreign material.
• Explain the process of granulation/proliferation during wound healing.

  New tissue begins to form, primarily consisting of granulation tissue composed of blood vessels, fibroblasts, and extracellular matrix.
• How does the remodelling/maturation phase contribute to wound healing?

  The newly formed tissue undergoes remodeling and maturation, increasing tensile strength and durability. Myofibroblasts reduce the size of the wound, and over time, the scar matures, becoming less noticeable and stronger.
• What are some complications of wound healing mentioned in the text?

  Hematoma, Seroma, Infection, Fistula, Dehiscence, Hypertrophic scars, Keloids
• Name some factors that can lead to prolonged wound healing.

  Diabetes mellitus, Vitamin C deficiency, Malnutrition, Long-term steroid therapy, Rheumatoid arthritis, Malignant diseases
• What are some steps of first aid for wound management?

  Control bleeding, Wound cleaning, Antisepsis, Wound covering, Immobilization, Tetanus shot
• How does the body control bleeding during the haemostasis phase?

  Through vasoconstriction and platelet aggregation, forming a blood clot to seal off the wound.
• What role do white blood cells play in the inflammation phase of wound healing?

  White blood cells, particularly neutrophils and macrophages, migrate to the wound site to clear debris, bacteria, and foreign material.