Introduction of patho part-5.pdfjooohgggh

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1. Program : BPT , II Year
PATHOLOGY
RAVINDRA SINGH JADON
CLINICAL INSTRUCTOR, NURSING(SONS)
Unit No. 01
INTRODUCTION OF PATHOLOGY
PART-5
LECTURE NO:-05

2. Outlines
•Woundhealingandrepair.
•Objectives.
•Healingbyfirstintention.
•Healingbysecondintention.
•Stagesofthewoundhealing.
•Factorsaffectingwoundhealing.
•Learningoutcomes.
•SELO(studentseffectivelearningoutcome)
•References.
BPT201 <Page No.1>

3. •Woundhealingandrepair:-
<Page No.2>
•Healing is one of the body response to injury is a attempt to restore
the normal structure and function.
•A wound is a break in the integrity of the skin or tissues often which
may be associated with disruption of the structure and function.
• A cut or break in the continuity of any tissue, caused by injury or
operation.
SELO-1,2
BPT201
R1.2>

4. •Objectives
<Page No.3>
•The objectives are the students are able to understand the wound healing
and types and cell participation in wound healing and factors affecting
wound healing.
BPT-201

5. •TypesofWoundhealing:-
<Page No.4>
❖TYPES OF WOUND HEALING:-
•1-Healing by first intention (wounds with opposed edges)
•2-Healing by secondary intention (wounds with separated edges)
➢Regeneration:-
✓Based on the capacity of regeneration the cell in the body grouped in
to 3 types:-
SELO-1,2
BPT-201
R1.2>

6. <Page No.5>
❖1-Labile cell:-These are divide continuously throughout life span.
eg:-Bone marrow cell, skin etc.
❖2-Stable Cell:-Divide when stimulate.
eg:-Liver, osteoblast, renal tubules.
❖3-Permanent cell:-Do not have the capacity to divide under any
circumstances.
eg:-Neurons, cardiac muscle cells.
SELO-1,2
BPT-201
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7. •Cellparticipationinwoundhealing:-
<Page No.6>
•Leukocytes.
•Macrophages.
•Connective tissue.
•Neutrophills.
✓NOTE:-Proliferation:-Growth or producing of cells by
multiplication.
SELO-1,2
BPT-201
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8. •1-HealingbyfirstIntention:-
<Page No.7>
Incision is filled with blood clot.
fibrin bridges opposite edges
upper surface of clot gets dried
Incision of Neutrophills below SCAB.
SELO-1,2
BPT-201
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9. <Page No.8>
1-3 day epithelial proliferation
Neutrophills replaced by macrophages(granulation tissue)
3-5 days surface epithelium fully restored.
by 2 weak collagen deposited
by 1 month wound healed.
SELO-1,2
BPT-201
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10. 2-Healingbysecondaryinfection:-
<Page No.9>
•Refer to healing of large wounds of all infected wounds.
•Myofibroblast can not bridges the wound edges so, granulation tissue
remains exposed and healing is slow resulting in thick scar.
•Inflammation reaction is service.
•Presence of wound contraction.
SELO-1,2
BPT-201
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11. Stagesofwoundhealing
<Page No.10>
❖Stage 1: Stop the bleeding (homeostasis)
•When you get a cut, scratch, or other wound in your skin, it usually
starts bleeding. The first stage of wound healing is to stop the
bleeding. This is called homeostasis.
•Blood begins to clot seconds to minutes after you get a wound. This
is the good kind ofblood clotthat helps to prevent too much blood
loss. Clotting also helps to close and heal the wound, making a scab.
SELO-1,2
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12. 2-Stage2:Scabbingover(clotting)
<Page No.11>
❖Clotting and scabbing phase has three main steps:
1-Blood vessels around the wound narrow. This helps to stop the
bleeding.
2-Platelets, which are the clotting cells in blood, clump together to make
a “plug” in the wound.
3-Clotting or coagulation includes a protein calledfibrin. It’s “blood
glue” that makes a net to hold the platelet plug in place. Your wound
now has a scab over it.
4-Inflammation, which involves cleaning and healing
5-Once your wound isn’t bleeding any more, the body can begin
cleaning and healing it.
SELO-1,2
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13. Stage 3: Rebuilding (growth and proliferative)
<Page No.12>
•Once the wound is clean and stable, your body can begin rebuilding
the site. Oxygen-rich red blood cells come to the site to create new
tissue. It’s like a construction site, except your body makes its own
building materials.
•Chemical signals in the body tell cells around the wound to make
elastic tissues called collagen. This helps to repair the skin and tissues
in the wound. Collagen is like a scaffold that other cells can be built
on.
•At this stage in healing, you might see a fresh, raised, red scar. The
scar will slowly fade in color and look flatter.
SELO-1,2
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14. Stage 4: Maturation (strengthening)
<Page No.13>
•Even after your wound looks closed and repaired, it’s still healing. It
might look pink and stretched or puckered. You may feel itching or
tightness over the area. Your body continues to repair and strengthen
the area.
SELO-1,2
BPT-201
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15. •Factorsaffectingwoundhealing:-
<Page No.14>
❖1-Infection:-Most important local cause delaying healing.
❖2-Mechanical factor:-Movement of wounded area can result in
delayed healing.
❖3-Foreign Bodies:-Unnecessary suture or glass or bone delay healing.
❖4-Size and the type of wound:-small wounds heal more quickly large
wounds.
❖5-Location:-Wound healing is delayed at sites in which skin covers
bone little tissue.
BPT-201
<R1, R2>
SELO-1,2

16. <Page No.15>
❖6-Blood supply:-Wound in area of good blood supply heals fast
(ex:-face) then wounds in areas of poor blood supply (ex:-foot).
BPT-201
<R1, R2>
SELO-1,2

17. •Systemicfactors:-
<Page No.16>
•1-Nutrition:-Protein deficiency, vitamin-c deficiency can cause delay.
•2-Age:-Wound heals fast in young age than old age.
•3-Metabolic status:-Diabetes mellitus is associated with delayed
healing.
•4-Circulatory status:-Inadequate blood supply or venous
abnormalities.
•5-Hormones:-Steroid inhibit collagen synthesis, thereby impaired
healing.
BPT-201
<R1, R2>
SELO-1,2

18. <Page No.17>
•Hematological abnormalities:-Defects in neutrophills and bleeding
disorder may slow healing process.
BPT-201
<R1, R2>
SELO-1,2

19. Assignment/Exercise
<Page No.18>
•Learn and make a assignment on wound healing.
BPT-201

20. LearningOutcomes
<Page No.19>
•Students will able to know what is the wound healing and how it
works.
•Students will be able to know the types and symptoms of the wound
healing and the stages of the wound healing.
BPT-201

21. SELO
<Page No.20>
•1. Adaptive thinking skills
•2. Ability to observe and develop logical skills for abstract concepts.
BPT-201

22. References
<Page No.21>BPT-201
•1. Textbook of pathology 6
th
edition Harsh Mohan, jaypee
publication.
•2. www.google.co.in/healthline/woundhealing.