Question

During healing of skin wounds, the sequence of events occurring during healing by second intention (secondary union) are:
A. Inflammatory phase
B. Initial hemorrhage
C. Granulation Issue
D. Wound Contraction
E. Epithelial Changes
Choose the correct answer from the options given below:

• A. B, A, E, C, D
• B. B, E, A, C, D
• C. B, A, C, D, E
• D. B, A, C, E, D

Hint:

In wound healing, remember: bleeding first, inflammation second, tissue formation third, contraction fourth, and epithelialization last.

Answer 1

The Correct Option is C

Step 1: Recall wound healing types.
Wound healing occurs either by primary intention (clean wounds with edges approximated) or by secondary intention (large tissue loss, wound left open, requiring granulation tissue formation). Healing by secondary intention is slower and leaves more scar tissue.
Step 2: Sequence of events in secondary intention.
1. Initial hemorrhage (B): Immediately after injury, bleeding occurs leading to clot and fibrin deposition.
2. Inflammatory phase (A): Neutrophils and macrophages infiltrate the wound to remove debris and pathogens. This phase is crucial for cleaning the wound.
3. Granulation tissue formation (C): Fibroblasts proliferate, new capillaries grow, and granulation tissue fills the wound gap.
4. Wound contraction (D): Myofibroblasts contract the wound margins, reducing the size of the defect.
5. Epithelial changes (E): Finally, epithelialization occurs, covering the wound surface and completing the healing process.
Step 3: Analyze the options.
- Option (A) B, A, E, C, D: Incorrect sequence, epithelialization does not occur before contraction.
- Option (B) B, E, A, C, D: Incorrect sequence, epithelialization cannot occur immediately after hemorrhage.
- Option (C) B, A, C, D, E: Correct order of events.
- Option (D) B, A, C, E, D: Incorrect, epithelialization occurs at the end.
Step 4: Conclusion.
The correct sequence in secondary intention healing is Initial Hemorrhage → Inflammatory Phase → Granulation Tissue → Wound Contraction → Epithelial Changes.