title: [Simple and complicated surgical wounds].
abstract: Aiming at primary wound healing, the majority of surgical interventions end with a wound closure. The wound edges are brought together and secured using sutures, staples or glue, respectively. A common surgical wound therefore tends to undergo an orderly and timely repair process with the result of sustained restored anatomic and functional integrity. In case of surgical wound infection, dehiscence, seroma or hematoma tissue repair is impaired and the healing process becomes delayed. Here, a simple wound becomes more complex or even chronic. Delayed wound healing continues to be a problem with associated significant morbidity and impaired quality of life that take up substantial health care resources. In situations of complicated or chronic wound setting the aim of wound healing will be by secondary intention referring to an open wound. Wound dressings, usually applied after wound closure, provide physical support and protection from bacterial contamination. In open wound, dressings not only have the protective intention but also clean the wound and induce the healing process. Further measurements of wound dressings in complicated wounds are pain relief, ease of use and removal on an outpatient basis, cost-effectiveness and patient satisfaction. Advances in the basic science of wound healing and its clinical application have led to numerous new therapies, products, and modalities that are constantly changing the approach to wound management. In the last two decades, negative-pressure wound therapy has been one of the major innovations in wound care. In addition to acting as an occlusive dressing, it may increase blood flow to the wound site, decrease edema, decrease bacterial contamination, and promote wound contraction. Further strategies to enhance wound healing or scar formation still under investigation include growth factors or regenerative cell therapy.
authors.affiliation: Allgemeinchirurgische Klinik, Universitätsspital Basel. misteli@uhbs.ch
authors.forename: Heidi
authors.initials: H
authors.lastname: Misteli
authors.forename: Daniel
authors.initials: D
authors.lastname: Kalbermatten
authors.forename: Christina
authors.initials: C
authors.lastname: Settelen
mesh_terms: D006406:Hematoma / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D049291:Seroma / Q000503:physiopathology / Q000628:therapy*; D013529:Surgical Wound Dehiscence / Q000503:physiopathology / Q000628:therapy*; D013530:Surgical Wound Infection / Q000503:physiopathology / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology*