2. Proliferation/reconstruction: 2-24 days. Phagocytosis continues, Angiogenesis: new blood vessels = new vascular network = energy for wound. Epithelial cells from outside move in to cover, mitosis thickens. Wound contraction.
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Describe the 3rd stage of wound healing
3. Maturation/remodeling: 24 days - 1 yr. Tensile strength increases, vascularity and scar size decrease
Infection, hypergranulation, hypertrophic/keloid scars (overgrowth dense fibrous tissue) but keloid expand beyond edge and x resolve well, contractures( short muscles) haemorrhage, haematoma (blood beneath tissue) Evisceration (protrusion of organ)
11 of 26
What is dehiscence?
Ruptured wound, increases discharge from wound 3-4 days after op
12 of 26
Discuss ARTERIAL ulcers
Due to blood x reaching extremities, toes, feet. When legs elevated blood flow reduced even more, lowered = pain relieved. Decreased or absent leg pulses, deep wound, slow cap refill, can = gangrene
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Discuss VENOUS ulcers
Has enough blood but excess fluid means it x travel back up leg, elevated = pain relieved, normal leg pulses ruddy granulation, uneven edges, oedema, tissue breakdown
Sharp: Removal w. sterile sharp instruments no blood or pain - competent practioner. Surgical: " aseptic envi - med practitioner. Mechanical: damp to dry dressing or irrigation under pressure. Biological: maggots. Enzymatic/chem: debriding enzymes
18 of 26
What does a score of 9 or less mean on Braden Scale
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