Surgery Book

WoundAka: Wound Healing


  1. Types
    1. Acute wounds
      1. Surgical wound
      2. Penetrating wound (e.g. knife or bullet wound)
      3. Avulsion Injury (e.g. finger tip amputation)
      4. Crushing or shearing Injury
      5. Burn Injury
      6. Laceration (See Laceration Repair)
      7. Bite wound (e.g. Dog Bite, Cat Bite, Human Bite)
    2. Chronic wounds
      1. Arterial ulcer (Peripheral Vascular Disease)
      2. Venous Ulcer (Venous Insufficiency)
      3. Lymphedema
      4. Pressure Ulcer (Decubitus Ulcer)
      5. Neuropathic ulcer (Diabetes Mellitus)
  2. Prognosis: Factors associated with impaired wound healing
    1. Chronic Disease
      1. Diabates Mellitus
      2. Peripheral Vascular Disease
      3. Chronic Renal Failure
    2. Malnutrition
      1. See Nutrition in Wound Healing
    3. Immunosuppression
      1. Topical Corticosteroids (e.g. Triamcinolone)
      2. Systemic Corticosteroids over 10 mg per day
      3. Chemotherepeutics (e.g. Methotrexate)
    4. Petrolatum or vaseline (however, good skin protectant)
    5. Topical antiseptics
      1. Topical Alcohol
      2. Hexachlorophene
      3. Povidone-Iodine 1% (Betadine 1%)
      4. Hydrogen peroxide 3%
      5. Chlorhexidine 0.5%
    6. Topical hemostatic preparation
      1. Monsel's Solution (Ferric subsulfate)
      2. Aluminum chloride 30%
      3. Silver nitrate
  3. Prognosis: Factors associated with improved wound healing
    1. Moisturizing Lotions (e.g. Eucerin, Aquaphor)
    2. Silver sulfadiazine (Silvadene cream)
    3. Topical antibiotic (e.g. Bacitracin)
      1. Avoid neosporin due to Allergic Contact Dermatitis
    4. Nonadherant Dressing (e.g. Telfa)
  4. Management
    1. See specific wound types
    2. See Wound Cleansing
    3. See Wound Debridement
    4. See Wound Dressing
  5. Course: Wound Healing
    1. Epithelialization (Sealing of wound) by 48 hours
    2. Peak collagen formation by 7 days
    3. Wound tensile strength 20% of full by 3 weeks
    4. Wound tensile strength 60% of full by 4 months
    5. Wound tensile strength never exceeds 80% of full
    6. Mature scar forms by 6 to 12 months
    7. Factors suggesting increased wound healing time
      1. See impaired wound healing above
      2. Increased wound width
      3. Wounds created by destructive technique
        1. Cryosurgery
        2. Electrosurgery
        3. Laser surgery
  6. References
    1. Bello (2000) JAMA 283(6):716
    2. Degreef (1998) Dermatol Clin 16(2):365
    3. Findlay (1996) Am Fam Physician 54(5):1519
    4. Habif (1996) Clinical Derm, Mosby, p. 810-13
    5. Knapp (1999) Pediatr Clin North Am 46(6):1201
    6. Krasner (1995) Prevention Management Pressure Ulcers
    7. Lewis (1996) Med-Surg Nursing, Mosby, p. 199-200
    8. Lueckenotte (1996) Gerontologic Nurs., Mosby, p. 800-7
    9. PUGP (1995) Am Fam Physician 51(5):1207
    10. PUGP (1994) Pressure Ulcer Treatment, AHCPR 95-0653
    11. Way (1991) Current Surgical, Lange, p.95-108

Wound Healing (C0043240)

Definition (MSH)Restoration of integrity to traumatized tissue.
Definition (CSP)restoration of integrity to traumatized tissue.
Definition (GO)The series of events that restore integrity to a damaged tissue, following an injury. [GOC:bf, PMID:15269788]
Definition (NCI)Restoration of diseased or damaged tissues naturally by healing processes or artificially, as by surgical means.
ConceptsOrganism Function (T040)
EnglishFinding of wound healing, Healing, Healing following injury, Observation of wound healing, Repair following injury, Tissue repair, Wound Healing, Wound Healings, Wound Repair
Spanishcicatrizacion, cicatrizacion luego de una lesion, curacion de herida, curacion de la herida - hallazgo, curacion de una herida, estructura originada en un proceso de reparacion tisular, reparacion histica, reparacion tisular
Parent ConceptsNatural regeneration (C0034963), Nutritional and Metabolic Diseases (C0028715), response to wounding (C1155347), Wound finding (C0558150), Morphologically altered structure (C1260954), Duplicate concept (C1274013)
Derived from the NIH UMLS (Unified Medical Language System)

wound care (C0886052)

ConceptsTherapeutic or Preventive Procedure (T061)
EnglishAdministers care to wound sites, Administers care to wound sites., wound care
Spanishatencion de una herida
Parent ConceptsAttention to wounds and operation sites (C0411803), Duplicate concept (C1274013)
Derived from the NIH UMLS (Unified Medical Language System)

Navigation Tree