Plastic Surgery Essentials for Students-Chapter 5: Wounds

Chapter 5: Wounds

Pdf Summary

The document provides a comprehensive overview of wound management, authored by Tulsi Roy, MD, and Michele Manahan, MD, FACS. It begins with the definition of a wound as any disruption of normal tissue relationships, resulting from either intentional or accidental injuries, such as surgical incisions or trauma.<br /><br />Wound healing is a multiphased process that includes inflammation, fibroblast proliferation, and remodeling, and is influenced by both local and systemic factors. The inflammatory phase (1-4 days) involves a physiological response that recruits immune cells to the wound site. The proliferative phase (4-42 days) sees the establishment of a fibrin clot and angiogenesis, with collagen synthesis peaking and contributing to tensile strength. Finally, the remodeling phase (4 weeks to 1 year) involves tissue maturation and scar formation, achieving up to 80% of the original tensile strength of the skin.<br /><br />Factors affecting wound healing are divided into local factors, such as blood supply and infection, and systemic factors like nutrition and chronic illness. Wound closure techniques (primary, secondary, and tertiary intention) are outlined, emphasizing adequate debridement and control of infection for optimal healing.<br /><br />The document outlines management strategies for both clean and contaminated wounds, emphasizing debridement, irrigation, and the role of antibiotics and dressings. Dressing types, including antibacterial ointments and negative pressure wound therapy (NPWT), are discussed for their roles in protection and promoting healing.<br /><br />Special considerations for different types of wounds, such as animal bites and face wounds, and strategies for managing contaminated wounds are provided. The document underlines the importance of holistic approaches to wound care to prevent infection and ensure optimal healing. References to scientific literature further support these practices, offering insights into advanced techniques and healing dynamics.

Keywords

wound management

wound healing

inflammation phase

proliferative phase

remodeling phase

wound closure techniques

debridement

negative pressure wound therapy

antibiotics

holistic wound care