Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ Test Taking Tips Questions tend to revolve around the physiology of how wounds heal, that is, secondary intention, myofibroblasts, and which cells are involved in wound healing. The strength layer of bowel and skin is also commonly tested. One should also be familiar with which organs lack certain tissue layers, such as the esophagus with no serosa, and where the posterior rectus sheath starts and stops. +++ Name the 3 phases of wound healing: ++ Inflammation (1–6 days), proliferation (3 days–3 weeks), maturation (3 weeks–1 year) +++ Name several factors that can inhibit wound healing: ++ Diabetes, infection, ischemia, malnutrition, radiation, steroids, neoplasia, anemia +++ What are the optimal nutrition parameters? ++ Albumin >3 g/dL and prealbumin >16 mg/dL +++ What is primary wound closure (primary intention)? ++ Immediate closure of a wound with suture or staples +++ Most important factor in healing closed wounds by primary intention: ++ Tensile strength +++ What is the most important layer to close for strength in skin lacerations? ++ Dermis +++ How long does it take a surgical incision to become “watertight”? ++ 24 to 48 hours +++ What is secondary wound closure? ++ Leaving a wound open and allowing it to heal by granulation, contraction, and epithelialization over time +++ Most important factor in the healing of open wounds by secondary intention: ++ Epithelial integrity +++ What causes contraction in wounds healing by secondary intention? ++ Myofibroblasts +++ What is delayed primary closure? ++ Closing a wound several days (3–5 days) after incision +++ Rate of regeneration of a peripheral nerve: ++ 1 mm/d or 1 in./mo +++ Rate of epithelialization: ++ 1 to 2 mm/d +++ The strongest layer of the bowel: ++ Submucosa +++ The time period that a small-bowel anastomosis is at its weakest: ++ 3 to 5 days +++ Name the 2 major events in the process of epithelialization: ++ Migration and mitosis +++ Name the process by which keratinocytes pile up on top of each other at the leading edge of a migration and tumble forward over the top of the heap: ++ Epiboly +++ What cell is the most essential for wound healing? ++ Macrophage +++ This cell is responsible for the movement and contraction of wound edges: ++ Myofibroblast ++... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.