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?
While epithelialization is responsible tor the healing of a closed incision, wound contraction is the primary method of closure in open wounds. During this process, the skin surrounding the wound is pulled over the wound surface and may account for up to a 90% reduction in the size of an open wound. In areas of greater adherence of skin to underlying tissue, the ability of contraction to close the wound is hindered due to the decreased mobility of the skin, Therefore, in areas of tight skin adherence such as the leg, contraction may only account for- 30 to 40% reduction in wound size. Fibroblasts in the open wound, which predominate during the proliferative phase, contain increasing numbers of actin microfilaments, thereby becoming myofibroblasts, These specialized fibroblasts are thought to be responsible tor wound contraction either through intrinsic cellular contraction or attachment to collagen strands.
It is the primary process affecting closure of a sutured or stapled surgical wound
Bacterial colonization significantly slows the process of contraction
It may account for a maximum of 50% decrease in the size of a wound
It is based on specialized fibroblasts that contain actin myofilaments