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Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
Wound bed, wound edge and periwound skin should be examined before the initial treatment plan is devised. It should also be re-assessed at each visit or each dressing change. For wound bed, the following parameters are assessed: Tissue type; presence and percentage of non-viable tissue covering the wound bed; Level of exudate; Presence of infection
If the injury is very minor, the epithelial cells eventually restore the epidermis once the dermis has been regenerated. In major injuries, the repair mechanisms are unable to restore the skin to its original condition. The repaired region contains an abnormally large number of collagenous fibers, and relatively few blood vessels.
Though treatment of the different chronic wound types varies slightly, appropriate treatment seeks to address the problems at the root of chronic wounds, including ischemia, bacterial load, and imbalance of proteases. [14] Periwound skin issues should be assessed and their abatement included in a proposed treatment plan. [17]
The surgical site or wound may allow the passage of air into the body. This most often occurs after abdominal and pelvic surgery. Treatment at this point becomes more complex depending upon the extent of the opening, where it occurs and if contents of the digestive system have entered the body. [2]
Since the year 2000, the wound bed preparation concept has continued to improve. For example, the TIME acronym (Tissue management, Inflammation and infection control, Moisture balance, Epithelial (edge) advancement) has supported the transition of basic science to the bedside in order to exploit appropriate wound healing interventions [6] and has not deviated from the important tenets of ...
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The fourth and final phase of wound healing, remodeling/scar formation, typically lasts 12 months but can continue as long as 2 years after the initial injury. [6] [7] Acute wounds can further be classified as either open or closed. An open wound is any injury whereby the integrity of the skin has been disrupted and the underlying tissue is ...