A 60-yrs-old diabetic man undergoes resection of an infected boil on his back. The wound is left open for packing and cleansing. Week by week, the wound grows smaller. Which of the following is true concerning wound contracture?
|A||It is the primary process affecting closure of a sutured or stapled surgical wound|
|B||Bacterial colonization significantly slows the process of contraction|
|C||It may account for a maximum of 50% decrease in the size of a wound|
|D||It is based on specialized fibroblasts that contain actin myofilaments|
a. All wounds undergo some degree of contraction. For wounds that do not have surgically approximated edges, the area of the wound will be decreased by this action (healing by secondary intention); the shortening of the scar itself results in contracture.
b. The myofibroblast has been postulated as being the major cell responsible for contraction, and it differs from the normal fibroblast in that it possesses a cytoskeletal structure.
c. The smooth muscle actin is undetectable until day 6, and then is increasingly expressed for the next 15 days of wound healing. After 4 weeks this expression fades and the cells are believed to undergo apoptosis.
a. While tissue integrity and strength are being re-established, the external barrier must also be restored. This process is characterized primarily by proliferation and migration of epithelial cells adjacent to the wound . The process begins within 1 day of injury