In which among the following wound healing process does the synthesis of collagen occur?

RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

Medical & Surgical Nursing

Easy

Appeared in: RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

Explanation

The granulation phase, also called the proliferative phase, begins around day 3-4 after injury.
This phase is characterized by the formation of granulation tissue, which fills the wound defect.
The key cells in this phase are fibroblasts, which actively synthesize and deposit collagen (initially Type III) and other extracellular matrix components.
This newly synthesized collagen provides the structural framework for the new tissue, a process known as fibrogenesis or fibroplasia.
Simultaneously, angiogenesis (formation of new blood vessels) occurs to supply the necessary oxygen and nutrients for this high-energy process.

Option A: The maturation phase is primarily about the remodeling and strengthening of collagen, not its initial synthesis. During this phase, the weaker Type III collagen is replaced by the stronger Type I collagen to increase the tensile strength of the scar.
Option B: The inflammatory phase focuses on cleaning the wound. It involves neutrophils and macrophages removing bacteria and debris. While macrophages release growth factors that stimulate the cells responsible for collagen synthesis, the actual production of collagen is not the main event of this phase.
Option C: The haemostasis phase is the immediate response to injury. Its sole purpose is to stop bleeding through vasoconstriction and the formation of a platelet plug and fibrin clot.

Visual 1: Diagram - A flowchart illustrating the four sequential phases of wound healing (Haemostasis, Inflammatory, Granulation, Maturation) with key cellular activities listed for each phase. This helps visualize the progression and where collagen synthesis fits in.
Visual 2: Microscopic Image - A histological slide showing granulation tissue. The caption should point out the abundant fibroblasts, newly formed capillaries (angiogenesis), and the loose extracellular matrix rich in newly synthesized collagen.

Clinical Relevance

Nursing practice connection: Knowing Phases of Wound Healing and Collagen Synthesis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a crucial role in assessing wounds and promoting healing. Understanding the phases helps in identifying signs of normal progression versus complications like infection or delayed healing.
Factors like poor nutrition (especially protein and Vitamin C deficiency), poor perfusion (e.g., in peripheral vascular disease or diabetes), and certain medications (like steroids) can impair the granulation phase and collagen synthesis, leading to chronic wounds.
A nurse's assessment of a wound's appearance (e.g., healthy red granulation tissue vs. pale, boggy tissue) provides direct insight into the effectiveness of the healing process.

How to Approach the Question

First, identify the core concept of the question, which is 'synthesis of collagen' in the context of 'wound healing'.
Recall the four main phases of wound healing: Haemostasis, Inflammatory, Granulation (Proliferative), and Maturation (Remodeling).
Associate the primary function with each phase.
Haemostasis = Stop bleeding.
Inflammatory = Clean the wound.
Granulation = Fill the wound (This involves building new tissue, which requires collagen).

Concept Tested & Keywords

QPSrnFrpDaOrO2zIVZNa6r