WOUND HEALING- Complications, Factors & Strength
| A | Age | |
| B |
Nutrition |
|
| C |
Dryness or wetness of wound |
|
| D |
a and b |
Wound healing is affected by:
| A |
Age |
|
| B |
Nutrition |
|
| C |
Dryness or wetness of wound |
|
| D |
a and b |
Ans. is ‘ a ‘ , ‘ b ‘
|
Factors that adversely affect wound healing |
|
• Local |
|
• Abnormal blood supply (ischemia due to arterial disease or impaired venous drainage, e.g. |
|
arteriosclerosis, varicose veins) |
|
• Infection |
|
• Presence of foreign material, necrotic tissue or excessive blood (hematoma) |
|
• Movement in injured area |
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• Tension in injured area |
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• Irradiation (decreases the viability of cells) |
|
• Denervation |
|
• Systemic |
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• Advanced age |
|
• Failure of collagen synthesis d/t |
|
– vitamin C deficiency |
|
– protein deficiency |
|
– zinc deficiency |
|
– Ehlers-Danlos syndrome (disorder characterized by defective collagen formation, |
|
hyperextensible joints, fragile tissues and impaired wound healing) |
|
• Diabetes mellitus |
|
• Corticosteroid excess (administration of exogenous corticosteroids or Cushing’s syndrome) |
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• Malnutrition |
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• Anemia |
|
• Obesity |
|
• Drugs (steroids, cytotoxic medication, intensive antibiotic therapy) |
|
• Genetic disorders (osteogenesis imperfecta, Ehler-Danlos syndrome, Marfan syndrome) |
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• Systemic infection |
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• Malignant disease |
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• Temperature |
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• Trauma, hypovolemia and hypoxia |
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• Uremia |
|
• Bleeding disorder |
| A | Vitamin -A | |
| B |
Vitamin – E |
|
| C |
Vitamin -C |
|
| D |
Vitamin B-complex |
Ans. is ‘b’ i.e., Vitamin-E.
- Systemic vitamin E and glucocorticoids inhibit the inflammatory response and collagen synthesis, thereby possibly impeding the healing process.
| A |
Local mesenchyme |
|
| B |
Epithelium |
|
| C |
Endothelium |
|
| D |
Vascular fibrosis |
Ans. is ‘a’ i.e. Local mesenchyme
Fibroblasts are specialized cells that differentiate from resting mesenchyme cells in connective tissue. They do not arrive in the wound cleft by diapedesis from circulating cells.
A patient of total parenteral nutrition develops delayed wound healing, loss of taste, deficient immunity and diarrhea. Most probably it could be due to deficiency of: September 2008
| A |
Selenium |
|
| B |
Copper |
|
| C |
Zinc |
|
| D |
Iron |
Ans. C: Zinc
Symptoms of Zinc Deficiency
- Poor Immune system
- Weight loss
- Intercurrent infections
- Hypogonadism in males
- Lack of sexual development in females
- Growth retardation
- Dwarfism
- Delayed puberty in adolescents
- Rough skin
- Poor appetite
- Mental lethargy
- Delayed wound healing
- Short stature
- Diarrhea
Congenital abnormalities causing zinc deficiency may lead to a disease called acrodermatitis enteropathica.
| A | Vitamin C | |
| B |
Vitamin D |
|
| C |
Vitamin A |
|
| D |
Niacin |
- Vitamin C is required for collagen synthesis.
- Due to its important role in collagen synthesis, vitamin C is required for adequate wound healing.
| A |
Inhibited by infection |
|
| B |
Inhibited by DM |
|
| C |
Inhibited by hematoma |
|
| D |
Inhibited by foreign body |
Ans. is ‘c’ i.e., Inhibited by hematoma
Factors causing impairment of wound healing
A. Systemic factors
- Poor nutrition (protein deficiency, vitamin C deficiency).
- Metabolic abnormalities (Diabetes mellitus).
- Poor circulatory status (Inadequate blood supply).
- Hormones, e.g. glucocorticoids.
B. Local factors
- Infection is the single most important factor.
- Mechanical factors, e.g. early mobilization.
- Foreign bodies (unnecessary sutures, fragments of steel or glass).
- Wound in poorly vacularized area, e.g. foot.
