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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.
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]
A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. [1] [2] Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying disease processes such as diabetes mellitus, venous/arterial insufficiency, or immunologic disease. [3]
Abrasions on elbow and lower arm. The elbow wound will produce a permanent scar. A first-degree abrasion involves only epidermal injury. A second-degree abrasion involves the epidermis as well as the dermis and may bleed slightly. A third-degree abrasion involves damage to the subcutaneous layer and the skin and is often called an avulsion.
The vertical mattress stitch has many effects due to its quadruple ability to achieve deep and superficial wound closure, edge eversion and precise vertical alignment of the superficial wound margins. Although, due to its time-consuming nature, many clinicians infrequently pursue such a technique.
Surgical wounds can become infected by bacteria, regardless if the bacteria is already present on the patient's skin or if the bacteria is spread to the patient due to contact with infected individuals. [5] Wound infections can be superficial (skin only), deep (muscle and tissue), or spread to the organ or space where the surgery occurred. [5]
Maceration is defined as the softening and breaking down of skin resulting from prolonged exposure to moisture. It was first described by Jean-Martin Charcot in 1877. [1] [2] Maceration is caused by excessive amounts of fluid remaining in contact with the skin or the surface of a wound for extended periods.
Passive drains rely on gravity or capillary action to remove fluid, whereas active drains rely on a suction/vacuum force, whether that be through connection to wall suction, a portable suction device, or a bulb that has been squeezed to create a vacuum. Open drains are commonly used for superficial wounds and drain into dressings or a stoma bag.