The basic principles of first aid to open wounds, which we frequently encounter in emergency departments, have not changed significantly in the last century, but the materials used in wound closure have changed with advancing technological developments. Especially topical anesthetic substances, tissue adhesives and fast dissolving strong> suture materials have changed patient comfort and wound healing results for the better.
The main purposes of intervention in open skin wounds are to prevent wound infection, stop bleeding and scar formation requires careful wound closure to produce the best cosmetic result.
Wound healing
One of the skin layers epidermis Strong> and dermis are the top two layers, and these two layers basically provide the main closure in skin repair, but in deep incisions, combining the subcutaneous layer, which is a lower layer, before the top layer, reduces the tension in the upper layer. Provides a better cosmetic result. The subcutaneous layer consists mainly of fatty tissue and contains nerve fibers, blood vessels and hair follicles. In incisions on the muscle layer, the fascia layer, which is the muscle sheath, is also likely to be damaged, and if there is a muscle incision, muscle repair must be done at the initial stage.
Wound healing begins following the first injury. In addition, after the wound lips are fully joined and closed with suture material, the top layer, the epidermis, is formed within 48 hours. The formation of new blood vessels reaches its fastest 4 days after the injury. Collagen formation is necessary for the wound site to become resistant to stress, and this process begins within 48 hours, is fastest in the first week, and remodeling takes up to 12 months.
Systemic diseases or ethnicity may affect wound healing. Renal failure, diabetes, nutritional status, obesity, chemotherapeutic agents, corticosteroids and anticoagulant or anti-platelet drugs as well as collagen tissue diseases can affect wound healing. Also s� Temperature, decreased tissue blood supply, tissue trauma and infection affect the wound healing process.
Another important determinant in wound healing is the injury mechanism and the presence of a foreign body. Healing will be very smooth in a straight cut made with a flat object on the skin, but in types of injuries where crushing, fragmentation and tissue loss occur, the amount of scar left after wound healing varies depending on the extent of the damage.
In wound healing, foreign wound originating from the wound. In cases of the presence of an object, a very dirty wound, delayed application (more than 24 hours on the face and scalp, more than 18 hours in other areas), and significant tissue or structure damage, it may be more appropriate not to close it but to leave it for secondary healing, as the risk of infection is high.
Delayed closure is also a method used in traumas such as human and animal bites or traumas with risk of infection. Depending on the condition of the wound, the wound site is closely monitored, the necessary antibiotic treatment is given and it can be closed at the appropriate time.
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