Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What skin structures primarily heal through scar formation?

1. Epidermis and capillary loops

2. Subcutaneous tissue, fascia, and muscle

3. Papillary dermis and reticular dermis

4. Epidermal appendages and papillae

The correct answer is: Subcutaneous tissue, fascia, and muscle

The primary structures that heal through scar formation are subcutaneous tissue, fascia, and muscle. When these deeper layers of the skin and underlying structures experience significant injury, such as surgical incisions or deep wounds, they typically undergo a healing process that involves inflammation, tissue regeneration, and often the formation of scar tissue. Scar formation occurs as a part of the healing process when tissue is damaged beyond the superficial layers, necessitating the body to replace lost or damaged tissue with fibrous connective tissue. This fibrous tissue lacks the same cellular architecture and functionality as the original tissue, resulting in a scar. Dense collagen is laid down in the area of the injury, which creates a new structural support but does not possess the same properties as normal skin, which can impact function and appearance. The other options involve structures that are either more superficial or have a different healing mechanism. For instance, the epidermis and papillary dermis generally heal with less scar formation involved, as they are more capable of regeneration. In contrast, the deep structures listed in the chosen answer focus on those layers where extensive repair usually leads to some scarring.