Running head: INFLAMMATION 1

Inflammation

Name

Institutional Affiliations
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Wound Infection Case Study (Cut)

Inflammation Physiological Mechanism

The event of a cut prompts the body to take action to prevent continuous bleeding that

may be dangerous to the patient. The first physiological mechanism therefore involves blood

clotting and scab formation after which healing of the wound begins to replace lost tissue. Guo &

DiPietro, (2010) explains that the clotting of blood exposed to the air on the wound leading to

scab formation has benefits other than preventing excessive loss of blood. During a cut as in the

case study, the scab forms only a few minutes to a couple hours for the blood to clot and the scab

to form. However, beneath, the wound the healing process continues gradually. The formation of

the scab therefore protects the wound from exposure to dirt debris and infectious pathogens (Guo

& DiPietro, 2010). The scab stays over the wound as it heals over time. Such should be the case

but most wounds end up infected especially due to the environment and the type of care. The

presence of other symptoms and the appearance of the wound help to determine presence of an

infection.

From the symptoms and the nature of the wound the caregiver should be able to offer the

best type of intervention to avoid a septic wound that may lead to a more serious infection. Guo

& DiPietro, (2010) explains that it is easy to identify an infected cut wound. The red gash,

swelling and warmer temperature on the wound suggests that there is a lot of action with the

body trying to fight the pathogens that are infecting the wound. The skin is usually the body’s

first line of defense and secrets the acid mantle that regulates skin pH maintaining the normal

flora microorganism on the skin that prevents entry of pathogens (Chen et al., 2018). Normal

flora rarely causes an immune reaction. With the immune system already affected any
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microorganism that gets to the wound may cause an infection leading up to symptoms such as

fever, edema and increased pain. Bacteria colonization is the first common infection and the

most prevalent bacterium in wound infections is the Staphylococcus aureus (Chen et al. 2018).

Complications emerge when such bacteria colonize areas that may be difficult to reach and treat

quickly such as the subcutaneous layers of the skin leading to cellulitis or the bone leading to

osyteomyelitis, or septicemia which involves an inflammation of the entire body due to bacteria

on the blood.

Wound and Internal Organ Inflammation Difference

Pathogens, dangerous compounds and dead cells are the main causes of inflammation in

the human body. Inflammation is the immune response from the body to the infection by

initiating healing or osmoregulation to remove the dangerous compound from the body. When an

inflammation affects the body internal organs then it is a chronic inflammation. However, the

manifestation of symptoms in an inflammation of a wound is different from those that involve an

internal organ. For instance the physical position of internal organs (without pain nerve endings

and where temperature changes are not that apparent), may lead to no pain or temperature change

for internal organ inflammation (Chen et al., 2018). Pneumonia, for instance, which is an

inflammation of the lung does not manifest as pain.

Immunological events in wound inflammation

The immunological response from the body usually depends on the type of the wound

and on the presence and type of infection. In this case study, Carlton, the patient is diagnosed

with a cut wound that is becoming infectious. Infection occurs during healing and the type of
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wound sounds like a normal cutaneous cut wound and if deep not too much to create a lethal

effect such as an inflammation of the blood. Ellis, Lin & Tartar, (2018) explains such cutaneous

healing to be a delicate process involving intricacies between the immune system and

keratinocytes and the dermal cells. The process of wound healing involves four main stages of

homeostasis, inflammation, proliferation and remodeling.

Homeostasis

During the homeostasis stage, the body creates action that increases the introduction of

the individual towards suppressing the blood loss caused by the injury. The homeostasis stage

therefore lasts only a few minutes and may not be more than a few hours for the body to readjust

to its normal functioning. The process is quite typical; first is a cascade of enzyme precursors

which are inert in their normal form, followed by activator proteins that ignite the serine protease

process that results in the activation of platelets and formation of fibrin clot (Ellis, Lin & Tartar,

2018).

Inflammation

The inflammatory stage quickly follows whereby the body gets rid of possible pathogens

that may have contacted the body, foreign debris and cell repair to prevent further tissue damage.

The stage is primarily characterized by neutrophil activation and formation. Neutrophils help in

infiltrating the wound and function by removing debris and preventing infection by

phagocytosing pathogens through releasing proteases and antimicrobial proteins (Ellis, Lin &

Tartar, 2018). Neutrophils therefore play the main role of transitioning the wound through its

healing process and even help in signaling the end of the inflammation stage leading up to

wound healing.
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Proliferation

The proliferation stage receives the name due to the proliferation of cells that facilitate re-

growth and repair of lost tissue. Some of the physiological processes during this stage include the

migration of keratinocytes, formation of granular cells, revascularization and regrowth of

epithelial tissue. The process involves a series of signals from immune cells and macrophages to

activate the healing process.

Repair/Remodeling

This is the last stage of the wound healing and is also the longest lasting from weeks to

even as long as years. During the remodeling the body and the skin is supposed to achieve its

original function and physical appearance. As such, the granulation stops and scarring occurs

where the weak collagen type III that lead to granulation are replaced by tougher type I collagen

(Ellis, Lin & Tartar, 2018). Myofibroplasts that form from mechanical tension on fibroplast lead

to the contraction of the wound.

Role of Vitamin A and C

Vitamin A and C play a substantial role in the healing process of a wound. Vitamin A for

one plays an instrumental role during the inflammation stage to facilitate the killing of pathogens

and to increase the body preventive capabilities against foreign microorganism. The role of

vitamin A involves increasing the inflammatory response through enhanced lysosomal

membrane lability, increases macrophage influx and collagen stimulation that encourages

healing (Chow & Barbul, 2014). Vitamin C similarly contributes to collagen formation and
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contraction of the wound during proliferation and reformation. Chow & Barbul, (2014) points

out that the vitamin is a co-factor in the production of lysine and proline residues of procollagen

that enhance toughness and stability of collagen fibres that help to recover the wound opening.

Vitamin A & C is thus vital in activating processes that lead up to the normal functioning of the

body from the inflammatory to the regrowth stages of healing.

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References

Chow, O., & Barbul, A. (2014). Immunonutrition: role in wound healing and tissue

regeneration. Advances in wound care, 3(1), 46-53.

Ellis, S., Lin, E. J., & Tartar, D. (2018). Immunology of wound healing. Current dermatology

reports, 7(4), 350-358.

Chen, L., Deng, H., Cui, H., Fang, J., Zuo, Z., Deng, J., ... & Zhao, L. (2018). Inflammatory

responses and inflammation-associated diseases in organs. Oncotarget, 9(6), 7204.