3 Wound healing and tissue repair

ABNORMAL WOUND HEALING Various factors can adversely a ff ect wound healing ( Summary box 3.1 ). S...

ACUTE WOUNDS Bites Most bites involve either puncture wounds or avulsions. Wounds over the metaca...

Acute compartment syndrome Acute compartment syndrome occurs when there is increased interstitial...

CHRONIC WOUNDS These wounds fail to progress through the normal stages of wound healing in a time...

CLASSIFICATION OF WOUNDS Wounds are diverse and there is no standard classification system that in...

Contractures Scar contractures can cause severe functional, psychological and aesthetic problems ...

Degloving Degloving is the avulsion of skin and subcutaneous fat from the underlying fascia, mus...

Haemostasis Disruption of the vascular endothelium following injury causes vasoconstriction and ...

INTRODUCTION Wound healing is a complex and dynamic biological process. In human adults, the norm...

Inflammation In the early inflammatory phase (days 1–2), platelet activation causes an influx of ...

Learning objectives To understand: Normal wound healing and how it can be adversely • affected Ty...

Leg ulcers 12 In developed countries, the most common chronic wounds It are leg ulcers. An ulcer ...

NORMAL HEALING IN OTHER SPECIFIC TISSUES Bone Bone healing occurs in similar phases to those for ...

NORMAL WOUND HEALING IN SKIN Classically , wound healing has been arbitrarily described in three ...

Necrotising fasciitis This is a severe, rapidly progressing infection of the soft tissue and fas...

Post exposure management for Tetanus Prone Wounds underappreciated and is not as simple as is oft...

Pressure ulcers Pressure ulcers occur over a bony prominence or under a medical or other device (...

Principles Clinical judgement is crucial in managing wounds. Some general principles of wound ma...

Proliferation The proliferative phase starts around day 3 and lasts for 2–4 weeks. It consists ma...

REFERENCES 1 Berard F , Gandon J. Postoperative wound infections: the influence of ultraviolet irr...

Remodelling The remodelling phase begins 2–3 weeks after injury and lasts for a year or more. Thi...

SCAR MANAGEMENT Principles The remodelling and maturation phase of wound healing results in scar...

TYPES OF WOUND HEALING There are di ff erent types of healing ( Summary box 3.2 Primary healing is...

Tendon Although repair follows the normal pattern of wound healing, there are two main mechanism...

WOUND MANAGEMENT Assessment Wound management is guided by the timing and mechanism of injury as w...