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Review
. 2021 Jun 16;9(2):45.
doi: 10.3390/medsci9020045.

Surgical Strategies to Promote Cutaneous Healing

Ines Maria Niederstätter  1 , Jennifer Lynn Schiefer  1 , Paul Christian Fuchs  1
Affiliations
Review

Surgical Strategies to Promote Cutaneous Healing

Ines Maria Niederstätter et al. Med Sci (Basel). .

Abstract

Usually, cutaneous wound healing does not get impeded and processes uneventfully, reaching wound closure easily. The goal of this repair process is to restore the integrity of the body surface by creating a resilient and stable scar. Surgical practice and strategies have an impact on the course of wound healing and the later appearance of the scar. By considering elementary surgical principles, such as the appropriate suture material, suture technique, and timing, optimal conditions for wound healing can be created. Wounds can be differentiated into clean wounds, clean-contaminated wounds, contaminated, and infected/dirty wounds, based on the degree of colonization or infection. Furthermore, a distinction is made between acute and chronic wounds. The latter are wounds that persist for longer than 4-6 weeks. Care should be taken to avoid surgical site infections in the management of wounds by maintaining sterile working conditions, using antimicrobial working techniques, and implementing the principles of preoperative antibiotics. Successful wound closure is influenced by wound debridement. Wound debridement removes necrotic tissue, senescent and non-migratory cells, bacteria, and foreign bodies that impede wound healing. Additionally, the reconstructive ladder is a viable and partially overlapping treatment algorithm in plastic surgery to achieve successful wound closure.

Keywords: buried skin graft; debridement; micrograft; plastic surgery; reconstructive ladder; split-thickness skin graft; wound healing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Relaxed skin tension lines.
Figure 2
Figure 2
Wound colonized with Pseudomonas aeruginosa.
Figure 3
Figure 3
The reconstructive ladder.
Figure 4
Figure 4
The reconstructive ladder: a combination of methods when conventional steps fail.
Figure 5
Figure 5
After wound closure by a combined method: Meeks and BSGs.
See this image and copyright information in PMC

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