Certified Wound Ostomy Nurse (CWON) Practice Test

What structures in the skin primarily heal through scar formation?

1. Epidermis and upper dermis

2. Epidermal appendages and subcutaneous tissue

3. Capillary loops and sensory nerves

4. Hair and sebaceous glands

The correct answer is: Epidermal appendages and subcutaneous tissue

The healing process through scar formation primarily involves the deeper layers of the skin, particularly when there is damage that extends beyond the epidermis. The epidermal appendages, such as hair follicles and sebaceous glands, are part of the skin's structure that can be adversely affected by injury, particularly deep wounds. When there is significant damage to these structures along with the subcutaneous tissue, healing will typically result in scar formation rather than complete regeneration. When an injury penetrates beyond the epidermis into the dermis and subcutaneous tissues, the body initiates a repair process characterized by inflammation, tissue formation, and remodeling. This process often results in the formation of fibrous tissue or scar tissue, which does not have the same structural integrity or function as the original skin. Therefore, the combination of damage to epidermal appendages and the underlying subcutaneous tissue is closely associated with the development of scars. In contrast, the epidermis and upper dermis have a high capacity for regeneration, and superficial injuries can often heal without significant scarring. The capillary loops and sensory nerves, while important components of the dermis, do not specifically indicate regions that lead to scar formation when damaged.