Case Study and Discussion – A 19-year-old With a Deep Laceration on the Left Leg

The selected case study for this discussion is the one involving a 19-year-old with a deep laceration on the left leg.

Pathophysiology of Wound Healing

The pathophysiology of wound healing undergoes through four overlapping stages. The first stage, hemostasis, occurs in the first to three days and involves the constriction of the blood vessels, reducing blood flow and loss. A blood clot is also formed as more platelets become available at the point of injury. Inflammation occurs in response to tissue injury. White blood cells, majorly neutrophils and macrophages, are triggered at the injury site to help remove all foreign material and fight and prevent infection (Bowers & Franco, 2020). This may cause pain, swelling, and redness around the injury site. As the clotting and inflammation occur, proliferation also occurs. In this stage, fibroblast synthesis of collagen (Type III), angiogenesis, and epithelization occur, creating new blood vessels and new tissues, respectively, closing the wound (Bowers & Franco, 2020). Finally, as collagen is continually produced, the new scar tissue strengthens, and the wound heals.

Granuloma and Its Significance

A granuloma is a focal aggregation of immune cells, majorly macrophages, formed due to continued inflammation (Williams & Fatima, 2022). The significance of granuloma is to eliminate infectious agents or irritants that are hard to remove from the body. Granulomas also may be indicators of underlying and existing conditions that continually cause inflammation, which can help in the diagnosis and management of certain medical conditions.

Graft versus Host Disease

Graft versus host disease (GvHD) can occur following an allogeneic haematopoietic stem cell transplantation (allo-HSCT) treatment or bone marrow transplant (Zeiser, 2019). It occurs due to the transplanted stem recognizing the recipient tissue cells as foreign and attacking them. It is a concern for the patient. Chronic GvHD can affect multiple organ systems, such as the skin and liver, leading to new complications or exacerbation of existing ones with a significant risk of death.

References

Bowers, S., & Franco, E. (2020). Chronic wounds: Evaluation and management. American Family Physician, 101(3), 159–166. https://www.aafp.org/pubs/afp/issues/2020/0201/p159.html

Williams, O., & Fatima, S. (2022). Granuloma. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK554586/

Zeiser, R. (2019). Advances in understanding the pathogenesis of graft-versus-host disease. British Journal of Haematology, 187(5), 563–572. https://doi.org/10.1111/BJH.16190

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Question

Deep Laceration on the Left Leg

Part 1: Choose a condition from the following case studies (Week 6 Case Study Details).

Part 2: Select two different students/topics, discuss the condition encompassing clinical experiences, and critique the post.

A 19-year-old presents with a deep laceration on the left leg. After sutures are placed, the patient is discharged.

Discuss the pathophysiology of wound healing.
What is a granuloma, and what is its significance?
Discuss graft versus host disease. Would this be a concern for the patient? Discuss your answer.