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The adoption of moist wound dressing technique as recommended best wound dressing practice reflected a large advance in approach producing markedly superior clinical outcomes. This dawn of modern wound care treatment initiated a process of improvement in the clinician's ability to bolster wound-site re-epithelialization and healing.
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.
Healing of a wound begins with clot formation to stop bleeding and to reduce infection by bacteria, viruses and fungi. Clotting is followed by neutrophil invasion three to 24 hours after the wound has been incurred, with mitoses beginning in epithelial cells after 24 to 48 hours. [citation needed]
A week after the injury, the edges of the wound are pulled together by contraction. Contraction is an important part of the healing process when damage has been extensive, and involves shrinking in size of underlying contractile connective tissue, which brings the wound margins toward one another. [1]
Jenkin's rule was the first research result in this area, showing that the then-typical use of a suture-length to wound-length ratio of 2:1 increased the risk of a burst wound, and suggesting a SL:WL ratio of 4:1 or more in abdominal wounds. [19] [20] A later study suggested 6:1 as the optimal ratio in abdominal closure. [21]
The operation involved the removal of the distal third of the left lower leg. The person survived the operation and lived for another 6 to 9 years. This is the only known surgical amputation carried out before the Neolithic Revolution and its farming transition. The next oldest known amputation was carried out about 7000 years ago on a farmer ...
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An increasingly common aid to both pre-operative wound maintenance and post-operative graft healing is the use of negative pressure wound therapy (NPWT). This system works by placing a section of foam cut to size over the wound, then laying a perforated tube onto the foam. The arrangement is then secured with bandages.