Management of Acute and Chronic Open Wounds: The Importance of Moist Environment in Optimal Wound Healing

Abstract

The history of wound care and management closely parallels that of military surgery which has laid down the principles and dictated the practices of wound cleansing, debridement and coverage. From a treatment standpoint, there are essentially two types of wounds: those characterized by loss of tissue and those in which no tissue has been lost. In the event of tissue loss it is critical to determine whether vital structures such as bone, tendons, nerves and vessels have been exposed. It is also important to determine the amount of soft tissue contusion and contamination. In any case primary wound healing by early closure either primarily or with the help of grafts or flaps is preferred to secondary healing and wound contraction with subsequent contractures which interfere with range of motion and function. Whether the wound is acute or chronic, essential principles of wound care must be observed in order to avoid wound sepsis and achieve rapid and optimal wound healing. - Tissues must be handled gently. - Caustic solutions capable of sterilizing the skin should never be applied to the wound. It is desirable never to put anything in the wound that cannot be tolerated comfortably in the conjunctival sac. - All devitalized tissues must be debrided either hydrodynamically, chemically, mechanically or surgically. - All dead space must be obliterated. - Exposed vital structures must be covered by well vascularized tissues. An essential part of any wound management protocol is wound dressing. It cannot be too strongly emphasized that a wound dressing may have a profound influence on healing particularly of secondary type healing, a critical feature being the extent to which such dressing restricts the evaporation of water from the wound surface. A review of available dressing materials is reported with emphasis on the newly developed concept of moist environment for optimal healing. a practical guide for dressing selection is also proposed.

Biodegradable Polysaccharide Gels for Skin Scaffolds

“…Unfortunately, there are limited biocompatible and biodegradable materials available. Hydrogels have been used as an alternate artificial skin, because good hydration is the most important external factor responsible for optimal wound healing [11][12][13][14], as water is necessary for transport of nutrients to the growing cells. Hydrogels, however, are commonly not physically strong enough to mimic the tough, thin dermis [9].…”

Regioninės Anestezijos Įtaka Lėtinėms Kojų Žaizdoms Gydyti

“…Žaizda apibūdinama kaip normalios odos ir minkštųjų audinių struktūros ir funkcijos pažaida [1]. Normaliomis są-lygomis žaizdos gijimo procesas baigiasi visišku sugijimu.…”

Wound healing potential of naringin ointment formulation via regulating the expression of inflammatory, apoptotic and growth mediators in experimental rats

“…It is defined as commotion of the normal structure, function, and architecture of skin (Atiyeh et al, 2002). An acute wound in normal wound physiology and healing is anticipated to progress through the normal stages of wound healing, through an orderly sequence of physiological events that include homeostasis, inflammation, epithelialization, fibroplasia, and maturation (Meyer et al, 2003).…”