Wound Healing

Wound Healing Affiliated Hospital of Jining Medical College Dep. Mammary and Thyroid Surgery Zhu Kunbing

Completion • • • •

Keloids Hypertrophic scar Functional disorder Inflammatory reaction SIRS

Factors That Influence Wound Healing Systemic • Nutrition Protein deficiency and Vit. C deficiency inhibit collagen synthesis and retard healing.

• Circulatory Status inadequate blood supply usually caused by arteriosclerosis or venous abnormalities also impair healing.

• Hormones such as glucocorticoids will inhibit collagen synthesis.

Immune suppressant Chemotherapeutic agent Diabetics

Local •

Infection -cause delay in wound healing.

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Mechanical factors -such as early motion of

wounds cause delay in healing.

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Foreign bodies -such as unnecessary sutures

or fragments of steel, glass, or even bone can impede healing.

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Size, location, and type of wound - wounds in richly vascularized areas heals faster. Small wounds produced intentionally heals faster than larger ones caused by trauma.

Surgical Technique • Asepsis • Gentle handling of tissue • Hemostasis :double-edged sword

Wound Closure Hernia formation Excessively tight closure

Infection Poor blood supply

Dehisence

Delayed Primary Closure leaving wound open No infection Infection

To observe infection Closed with skip tapes Change dressing

Secondary closure

Postoperative Care • Nutrition • Basic diseases therapy cardiopulmonary diseases malnutrition • Pain

effective analgesic

• Blood volume oxygenation • Cleanliness

Thank you