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Inflammation and infection (Factors affecting wound healing (Circulation,…
Inflammation and infection
Acute
Stimuli: infection, microbial toxin, physical injury
Systemic Response
Whole body experience
Prostaglandins
Decrease energy/appetite, sweats, N/V/D
Interleukins
Mast cells
Release histamine
Arteriole vasodilation
More fluid accumulation resulting in runny nose, sneezing, teary eyes, pharyngeal irritation
large artery vasoconstriction
.
Pyrogens
Increase temperature (hypothalamic)
Vascular permeability
Inflammatory mediators
Bradykinin
Increase vasodilation
WBC's , fluids, platelets go to infection site
WBC's phagocytize foreign material
Fluid increases
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Increased permeability
Increased fluid
Fluid: dilutes toxins, lowers pH (acidic)
5 cardinal signs of inflammation
Redness, swelling, heat, pain, loss of function
Histamine
.
Chemotaxis
Platelets & WBC's alerted w/ chemical signals from microbes
Margination
Mediator release
Cytokines
CRP markers
Pro inflammatory
Anti inflammatory
Leukocytes
WBC's
Basophils
Neutrophils (first responders)
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Eosinophils
Diagnosis of infection is a WBC differential
Measure total # of WBC's
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When leukocytes leave systemic to respond to microbe activity and endothelial issues
Full resolution and tissue repair
Chronic
Normal wound healing
Processes of wound healing
Secondary intention
Regeneration of missing tissue, scar formation, increased risk of infection, contraction of wound edges
Tertiary intention
Large amount of tissue missing. Needs to be cleaned and left open for 4/5 days before closure. Prominent scarring. Skin grafts common.
Primary intention
Clean laceration, easily brought together, no missing tissue
Phases of wound healing
Proliferation, granulation, epithelization
wound contraction and remodeling
Inflammation
Factors affecting wound healing
Circulation
Immunity
Oxygenation
Contamination
Nutrition
Obesity
Age
Dysfunctional wound healing
Evisceration
opening of wound with extrusion of organs
Stricture
abnormal narrowing of a tubular body passage from the formation of scar tissue
Keloid
hyperplastic scar
Fistula
abnormal connection between two epithelium lined organs or vessels that normally don't connect
Adhesions
internal scar tissue between tissues or organs
Dehiscence
Opening of wounds suture line
Contratures
inflexable shrinkage of wound tissue
