Wound Healing

1.16.1 Discuss the three phases of wound healing.

1.16.2 Describe the different groups of growth factors in wound healing.

1.16.3 Discuss the different types of collagen and where they are found.

1.16.4 Tell us about the necessary cofactors of vitamins A & C, zinc and iron.

1.16.5 What role can hyperbaric oxygen and negative pressure wound systems be used for a healing, chronic wound?

1.16.6 How is fetal healing different from yours?

1.16.7 Discuss the impact of diabetes and hypothyroidism on wound healing.

1.16.8 Discuss the effects of smoking on wound healing.

Sorensen LT, Karlsmark T, Gottrup F. Abstinence from smoking reduces incisional wound infection: a randomized controlled trial. Ann Surg. 2003 Jul;238(1):1-5. PMID:12832959

1.16.9 How does chemotherapy impact healing?

1.16.10 Would you consider application of growth factors, therapeutic ultrasound and electrical/laser stimulation in promoting wound healing?

1.16.11 Your H&N cancer patient opted for organ preservation treatment of his T3N2a SCCA supraglottis. He now wants you to manage his 4x5 cm neck wound. On exam, it appears superficial, dry and clean, with no signs of healing. How does radiation impact healing?

1.16.12 Read the article below then educate us on wound care and dressings.

Hom DB, Adams G, Koreis M, Maisel R. Choosing the optimal wound dressing for irradiated soft tissue wounds. Otolaryngol Head Neck Surg. 1999 Nov;121(5):591-8. PMID:10547476

1.16.13 What are your thoughts on peri-operative antibiotics-what and how long?

1.16.14 Tell us about the role of the macrophage and lymphocyte in wound healing.

1.16.15 Tell us about the role of fibronectin, ground substance and collagen. When is the wound strong? Does it ever attain full strength of unwounded skin?

1.16.16 Tell us about the role of myofibroblasts and how contraction takes place.

1.16.17 What does infection do to the wound healing process?

Robson MC, Stenberg BD, Heggers JP. Wound healing alterations caused by infection. Clin Plast Surg. 1990 Jul;17(3):485-92. PMID:2199139

1.16.18 Your high maintenance cosmetic patient wants you to use the best suture for the prettiest wound.

Gabrielli F, Potenza C, Puddu P, Sera F, Masini C, Abeni D. Suture materials and other factors associated with tissue reactivity, infection, and wound dehiscence among plastic surgery outpatients. Plast Reconstr Surg. 2001 Jan;107(1):38-4. PMID:11176599

1.16.19 How are oxygen free radicals generated and what is their role in wound healing?

1.16.20 Discuss the classic principles of wound closure by Halstead.