Surgery>>>>>Wound Healing
Question 11#

How does diabetes mellitus impair wound healing?

A. Local hypoxemia, reduced angiogenesis, and inflammation due to vascular disease
B. Glycosylation of proteoglycans and collagen in wound bed due to hyperglycemia
C. Decreased collagen accretion noted in patients with type II diabetes mellitus
D. Increased bacterial load to due to hyperglycemia

Correct Answer is A

Comment:

Uncontrolled diabetes results in reduced inflammation, angiogenesis, and collagen synthesis. Additionally, the large and small vessel disease that is the hallmark of advanced diabetes contributes to local hypoxemia. Defects in granulocyte function, capillary ingrowth, and fibroblast proliferation all have been described in diabetes. Obesity, insulin resistance, hyperglycemia, and diabetic renal failure contribute significantly and independently to the impaired wound healing observed in diabetics.