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During the inflammatory phase of wound healing, which of the following events occur at the site of injury? Select all that apply

A.

Neutrophils are the first phagocytic cells to arrive.

B.

Vasodilation of local blood vessels.

C.

Platelets release growth factors and cytokines.

D.

Fibroblasts migrate into the wound to begin collagen synthesis.

E.

Increased vascular permeability.

Answer and Explanation

Correct Answer : A,B,C,E

During the inflammatory phase of wound healing, the body responds to injury by initiating immune and vascular processes to prevent infection and prepare the wound for tissue repair. Neutrophils are the first phagocytic cells to arrive, removing debris and bacteria. Local vasodilation increases blood flow, platelets release growth factors and cytokines to recruit immune cells, and increased vascular permeability allows plasma proteins and leukocytes to enter the wound site. Fibroblast migration and collagen synthesis occur later in the proliferative phase, not during inflammation.

Rationale for correct answers:
A. Neutrophils are the first phagocytic cells to arrive: Neutrophils infiltrate the wound within hours, removing pathogens and damaged tissue.
B. Vasodilation of local blood vessels: Mediated by histamine, prostaglandins, and nitric oxide, vasodilation increases delivery of immune cells and nutrients.
C. Platelets release growth factors and cytokines: These signals initiate inflammation and recruit additional immune cells to the wound.
E. Increased vascular permeability: This allows immune cells and plasma proteins to leave the bloodstream and enter the wound area for defense and repair preparation.

Rationale for incorrect answer:
D. Fibroblasts migrate into the wound to begin collagen synthesis: This is a hallmark of the proliferative phase, not the inflammatory phase.

Take home points

  • Inflammation involves immune cell recruitment, vasodilation, and increased permeability.
  • Platelets not only form clots but also signal immune and repair processes.
  • Fibroblast-driven collagen synthesis occurs later, after the wound is cleaned and prepared.


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Related Questions

Correct Answer is C

Explanation

The proliferation phase of wound healing is most likely to be delayed or inhibited by the presence of eschar and necrotic tissue. During proliferation, fibroblasts, keratinocytes, and endothelial cells work to form granulation tissue, re-epithelialize the wound, and promote angiogenesis. Necrotic tissue and eschar act as a physical and biological barrier, preventing cell migration, impeding oxygen and nutrient delivery, and increasing infection risk. Debridement is often required to progress healing.

Rationale for correct answer:
3. Proliferation: This phase depends on a clean wound bed for granulation tissue formation and epithelialization. Necrotic tissue and eschar block this process, trapping bacteria and preventing new tissue growth.

Rationale for incorrect answers:
1. Hemostasis: This occurs immediately after injury to stop bleeding and would have already taken place before the proliferation phase begins.
2. Inflammation: While necrotic tissue can prolong inflammation, it doesn’t prevent it; in fact, it often triggers more inflammatory activity.
4. Maturation: This is the final phase involving collagen remodeling and scar strengthening, which occurs after proliferation; it cannot proceed until earlier phases are completed.

Take home points

  • The proliferation phase requires a clean, well-vascularized wound bed.
  • Necrotic tissue and eschar must be removed to allow granulation and re-epithelialization.
  • Without debridement, wounds can stall in the inflammatory phase and fail to progress.

Correct Answer is C

Explanation

  • During the maturation phase of wound healing, fibroblasts play a key role in producing and remodeling the collagen matrix, which increases the wound’s tensile strength. Collagen fibers are reorganized from a random to a parallel alignment, and excess collagen is broken down to improve the functional and structural integrity of the repaired tissue. This phase can last for months to years, depending on the wound.

    Rationale for correct answer:
    C. Producing and remodeling the collagen matrix to increase tensile strength: Fibroblasts are responsible for ongoing collagen production and remodeling, which gradually restores the wound’s structural stability and reduces scar thickness.

    Rationale for incorrect answers:
    A. Clearing the wound of pathogens and dead cells: This is primarily the role of neutrophils and macrophages during the inflammatory phase.
    B. Forming a fibrin clot to stop bleeding: This is the function of platelets during the hemostasis phase.
    D. Creating new blood vessels to supply oxygen and nutrients: This occurs during angiogenesis in the proliferative phase, not during maturation.

    Take home points

  • The maturation phase focuses on collagen remodeling and increased tensile strength.
  • Fibroblasts remain active long after the wound has closed to optimize scar quality.
  • Full tensile strength is never completely restored—healed wounds typically regain about 80% of their original strength.

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