HEALING

1. Wound healing:a. Usually results in wounds achieving maximal strength by one monthb. Is characterized by neovascularisation becoming maximal by 48 hoursc. Is facilitated by steroidsd. By secondary intention is characterized by a more intense inflammatory responsee. Does not usually involve contraction in the size of the wound

2. Concerning the repair of a well opposed, clean surgical incisiona. Dermal appendages destroyed by the incision usually recoverb. New collagen begins to accumulate after the first weekc. Granulation tissue does not occurd. There is an initial inflammatory responsee. 15% of original tissue strength is attained after 1 week

3. With respect to wound healinga. ?b. ?c. neutrophils proliferate at the wound margins at the same time as epithelial proliferation occursd. ?e. ?

4. In healing by primary intentiona. There is a large tissue defectb. The tissue defect cannot be reconstitutedc. It involves excessive granulation tissued. An epithelial spur forms on the first day (24-48 hours)e. ?

5. Wound healinga. Is influenced by both cell-cell and cell-matrix interactionsb. Is characterized by neovascularisation within the first six hoursc. Is by secondary intention when a wound is created by a clean surgical incisiond. Leads to eventual scar formation within 24 hourse. Is considered abnormal if granulation tissue appears by day 5

6. With respect to wound healing, by day 3a. Neutrophils have been largely replaced by macrophages – 48 to 96 hoursb. Neovascularisation is maximal (5-7 days fills the wound)c. Collagen bridges the incisiond. Fibroblasts begin proliferating (24-72hr)e. The leukocyte infiltrate has largely disappeared

7. Removal of sutures from a wound at day 7 coincides with a wound strength ofa. 1% of unwounded skin strengthb. 10% of unwounded skin strengthc. 50% of unwounded skin strengthd. 75% of unwounded skin strengthe. 100% ie. Same as unwounded skin

8. Primary intention wound healinga. Epithelial spurs at margins at 24 hours (24 - 48 hours, so could also be correct)b. Marked wound contractionc. Granulation tissue at…d. Vitamin C deficiency and repaire. Single most important factor in delayed wound healing is infection – definitely correct

9. Regarding wound healing, what occurs at the same time?a. Neutrophils and basal epithelial mitosesb. Tensile strength and granulation tissuec. Neutrophils and granulation tissued. ?e. ?

10. Which of the following is an accurate pairing of the steps involved in wound healing by first intention?a. Filling of incisional space with blood clot + neovascularisationb. Appearance of neutrophils at wound margin + epithelial migration along cut margins of dermisc. Vertical orientation of collagen fibres + blanchingd. Surface keratinisation + wound contractione. Loss of dermal appendages + appearance of granulation tissue – late + early

11. After the initial injury a surgical skin wound will usually reach 70% of th tensile strength of unwounded skin ata. Day 5b. During the second weekc. By the end of the first monthd. By the end of the third monthe. A surgical wound cannot exceed a tensile strenth greater than 60% of unwounded skin

12. Wound healinga. Occurs by secondary intention in surgical woundsb. Is accelerated by glucocorticoidsc. Achieves maximal wound strength at two weeksd. Does not depend on site or size of wounde. Occurring by secondary intention involves abundant granulation tissue

13. Healing by first intention involves:a. An initial infiltration of macrophagesb. The growth of abundant granulation tissue from the edge of the woundc. The infiltrate of neutrophils into the clot within 24 hoursd. The formation of a scar within one weeke. The appearance of granulation tissue within 48 hours