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Plastic Surgery’s pre-eminence in the field of surgical wound management is enhanced with clinical information in this publication. A surgeon involved with an international team training surgeons throughout the world in wound technology leads this issue, presenting advances in wound technology. Wound technology has enabled plastic surgeons to treat a wide variety of wounds successfully and has transformed wound surgery to a thriving, cutting edge specialty. Topics include: Debridement; Microbial Barrier ...
Plastic Surgery’s pre-eminence in the field of surgical wound management is enhanced with clinical information in this publication. A surgeon involved with an international team training surgeons throughout the world in wound technology leads this issue, presenting advances in wound technology. Wound technology has enabled plastic surgeons to treat a wide variety of wounds successfully and has transformed wound surgery to a thriving, cutting edge specialty. Topics include: Debridement; Microbial Barrier Protection; Harnessing Growth Factors to Influence Wound Healing; Regenerative Materials that Facilitate Wound Healing; Compression and Venous surgery to treat VLUs; Early Experience with Stem Cells in treating Chronic Wounds; Hyperbaric Oxygen, Topical Oxygen and Nasal Oxygen in Wound Management; Negative Pressure Wound Therapy: An Algorithm; Sophisticated Surgical Solutions for Complex Wound Problems; An Algorithm for Limb Salvage for Chronic Ulcers; Outcome Assessment for Chronic Wound Management with Serial Debridement, and Topical Surface Manipulation.
Plastic Surgery's Critical Role in Wound Management Mark S. Granick ix
Debridement of Chronic Wounds: A Qualitative Systematic Review of Randomized Controlled Trials Ian C. Hoppe Mark S. Granick 221
This article reviews the current evidence available regarding wound debridement of chronic wounds and collates data from existing randomized controlled trials.
Microbial Barriers Luke G. Gutwein Mousumee Panigrahi Gregory S. Schultz Bruce A. Mast 229
Barrier wound therapy is commonplace in the health care environment and functions to limit bacterial colonization and infection in both acute wounds and recalcitrant chronic wounds. This article reviews the nature of acute and chronic wounds and their available adjunctive barrier therapies.
Harnessing Growth Factors to Influence Wound Healing Elizabeth Kiwanuka Johan Junker Elof Eriksson 239
Cutaneous wound healing is a dynamic process with the ultimate goal of restoring skin integrity. On injury to the skin, inflammatory ceils, endothelial cells, fibroblasts, and keratinocytes undergo changes in gene expression and phenotype, leading to cell proliferation, migration, and differentiation. Cytokines and growth factors play an essential role in initiating and directing the phases of wound healing. These signaling peptides are produced by a variety of cells and lead to a concerted effort to restore the skin barrier function.
Regenerative Materials That Facilitate Wound Healing Gerit Mulder Kelly Wallin Mayer Tenenhaus 249
Wounds and damaged tissue become problematic when the tissue repair process does not proceed in a normal manner. Standard treatment of wounds entails topical dressings and devices in conjunction with good wound care practices. Good practices adequately support healing in most patients. Difficult, chronic, or recalcitrant wounds may require the use of more advanced technologies. Wounds that are full thickness or present with the absence of a matrix, may particularly benefit from regenerative materials. This article focuses on the use of cellular and acellular materials as well as chemical constructs to support granulation, tissue repair, and wound closure.
Compression and Venous Surgery for Venous Leg Ulcers Giovanni Mosti 269
This article reviews published data on the effects of surgery and compression in the treatment of venous ulcers and the best options for compression therapy. Randomized controlled studies reveal that surgery and compression have similar effectiveness in healing ulcers but surgery is more effective in preventing recurrence. Most leg ulcers have a venous pathophysiology and occur because of venous ambulatory hypertension caused by venous reflux and impairment of the venous pumping function. Proposed surgical interventions range from crossectomy and stripping to perforator vein interruption and endovascular procedures (laser, radiofrequency). More conservative procedures (foam sclerotherapy, conservative hemodynamic treatment) have also been proposed.
Early Experiences with Stem Cells in Treating Chronic Wounds Sadanori Akita Hiroshi Yoshimoto Kozo Akino Akira Ohtsuru Kenji Hayashida Akiyoshi Hirano Keiji Suzuki Shunichi Yamashita 281
This review provides a thorough and clear discussion on the outcomes of stem cells in treating chronic wounds. With recent technological developments that now allow isolation and culture of stem cells, researchers are able to perform vigorous studies on somatic or adult stem cells. Human and animal stem cell studies are discussed with a focus on the basic process of stem cells in wound healing and the authors' first-hand clinical experience with stem cells used for chronic wound healing.
Oxygen in Wound Healing: Nutrient, Antibiotic, Signaling Molecule, and Therapeutic Agent David E. Eisenbud 293
Disturbances to healing observed under hypoxic conditions have given insights into the roles of oxygen. Wound hypoxia is more prevalent than generally appreciated, and occurs even in patients who are free of arterial occlusive disease. There is a strong scientific basis for oxygen treatment as prophylaxis against infection, to facilitate wound closure, and to prevent amputation in wounded patients. This article reviews extensive data from preclinical and human trials of supplemental inhaled oxygen, hyperbaric oxygen, and topical oxygen treatment. Oxygen supports biochemical metabolism and cellular function, and has roles in combating infection and facilitating the wound healing cascade.
Negative Pressure Wound Therapy: An Algorithm Kunj K. Desai Edward Hahn Benson Pulikkotill Edward Lee 311
Negative pressure wound therapy (NPWT) has overwhelmed the wound-healing world. A systematic review puts it into perspective. The authors have developed an algorithm after careful evaluation and analysis of the scientific literature supporting the use of these devices. This article describes mechanisms of action, technical considerations, wound preparation, and clinical evidence, reviews the literature, and discusses NPWT use in specific wounds, such as diabetic foot ulcers, open abdomen, pressure ulcers, open fractures, sterna wounds, grafts, and flaps. Contraindications for and complications of NPWT are outlined, and specific recommendations given for the situations in which the authors use NPWT.
Sophisticated Surgical Solutions for Complex Wound Problems Simon G. Talbot Julian J. Pribaz 325
This article is a discussion and presentation for plastic surgeons, in which each section is dedicated to a principle necessary for complex wound reconstruction. Each principle is discussed and includes detailed images of the associated operations.
An Algorithm for Limb Salvage for Diabetic Foot Ulcers Joon Pio Hong Tae Suk Oh 341
The treatment of diabetic foot ulceration is complex with multiple considerations often leading to limb amputation. This article presents the usefulness of a multidisciplinary approach along with an algorithm to manage and salvage diabetic foot ulcers from amputation. This algorithm is a step-by-step guide to manage the diabetic foot ulcer and can help one in the selection of patients for limb salvage reconstruction.