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Halsted's principles, also known as Tenets of Halsted, are the basic principles of surgical technique regarding tissue handling. [1] These key points were introduced in the late 19th century by William Stewart Halsted, co-founder of Johns Hopkins Hospital. [2] [3] Gentle handling of tissue; Meticulous haemostasis; Preservation of blood supply
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.
There are several small variations in the reconstructive ladder [2] [3] in the scientific literature, but the principles remains the same: Healing by secondary intention; Primary closure; Delayed primary closure; Split thickness graft; Full thickness skin graft; Tissue expansion; Random flap; Axial flap; Free flap
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 ...
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]
The wound usually appears red and can be accompanied by drainage. Clinicians delay re-opening the wound unless it is necessary due to the potential of other complications. If the surgical wound worsens, or if a rupture of the digestive system is suspected the decision may be to investigate the source of the drainage or infection. [2] [3]
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
Since blood flow is important for wound healing, TCOM is often used to gauge the ability of tissue to effectively heal. [1] To perform the test, one set of electrodes are placed on viable tissue (e.g. the chest) as a control and a second set is placed around the tissue in question (e.g. legs or feet).