After the wound healing, scar tissue is formed by?

DSSSB - 29 August 2019 (Shift-2)

Medical & Surgical Nursing

Easy

Appeared in: DSSSB - 29 August 2019 (Shift-2)

Explanation

Scar tissue is the body's natural way of patching an injury with fibrous connective tissue.
Fibroblasts are the key cells responsible for this process. They migrate into the wound during the proliferative phase.
These fibroblasts synthesize and deposit collagen, which is the main structural protein that gives scar tissue its strength.
Initially, weaker Type III collagen is laid down, which is later replaced by stronger Type I collagen during the maturation phase, strengthening the scar over time.

Option B: Macrophages are 'clean-up' cells. They are phagocytes that remove bacteria, dead cells, and debris from the wound. They also release growth factors that signal fibroblasts to come to the area, but they do not produce the collagen that forms the scar.
Option C: Neutrophils are the first-line defenders against infection. They are the first white blood cells to arrive at an injury site (within 24 hours) to kill bacteria. Their role is in the very early inflammatory stage, and they are not involved in building the scar tissue.
Option D: Osteoblasts are specialized cells that synthesize bone matrix. They are essential for healing bone fractures but have no role in the repair of soft tissues like skin.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Cellular basis of scar formation in wound healing in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Nurses play a vital role in promoting optimal wound healing by ensuring patients have adequate nutrition, particularly protein, vitamin C, and zinc, which are essential for collagen synthesis.
Proper wound care, such as maintaining a moist environment and preventing infection, supports the function of fibroblasts and other cells involved in repair.
Monitoring for signs of impaired healing is crucial. Factors like diabetes, poor perfusion, and the use of glucocorticoids can inhibit fibroblast activity and collagen deposition, leading to chronic wounds.

How to Approach the Question

First, identify the core concept of the question, which is the composition of scar tissue after wound healing.
Analyze the options provided, which are different types of cells.
Recall the physiological process of wound healing and the specific roles of different cells in each phase.
Differentiate between the cells responsible for inflammation and cleaning (neutrophils, macrophages) and the cells responsible for building new tissue (fibroblasts).
Eliminate options that are clearly incorrect, such as osteoblasts, which are involved in bone formation, not soft tissue repair.
Select the option that correctly identifies the building cells (fibroblasts) and the material they produce (collagen) to form the scar.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed pp. 118-120, 115-117

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 1 (1-214) p. 135-137