Lecture notes
questions about general surgery
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th6 year
قال رسول اهلل
ث ط ق ن
" إذا مات ابن آدم ا ع عمله إال من الث
ق ت ني لع
دقة جارية أو م ع يه أو ولد صالح ثدعو له "
>> ال ينسوثا من صالح دعاثكم <<
, General
Stages “phases” of Wound healing
1. Hemostasis & inflammation phase "5 days"
aggregation of platelets → coagulation cascade
macrophages→ phagocytosis, activation of fibroblast & endothelial
2. Proliferation phase
Proliferation → "Fibroblast, endothelial cells, epithelial cells"
3. Maturation & Remodeling phase
deposition of collagen III then, collagen I
Remolding continues for about one year
Types of Wound healing
1ry intention:
• clean incised wounds → closed immediately
• Minimal fibrosis → nice scar
2ry intention:
, Factors affecting wound healing
Age "Elder"
General Nutrition " nutrient important for healing"
🔘 Protein → Collagen synthesis
🔘 Vit C → Maturation of Proto-Collagen
🔘 Vit A → Epithelization
🔘 Calcium, Zinc, Copper, Manganese
Debilitating diseases “Uremia, Diabetes, C
Drug intake “Steroids, chemotherapy”
Irradiation “ Granulation tissue, ischemia d.t En
Vascularity
Local Immobilization
Tension "cause ischemia"
Infection "compete for O2 , secrete collagenase"
Foreign bodies & necrotic tissues
Adhesion of wound to a bony surface " w
Impaired Venous drainage
Complications of Healing:
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