Facial Plast Surg 2019; 35(06): 672-677
DOI: 10.1055/s-0039-1700889
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Complex Wound Management

Tom Shokri
1   Department of Otolaryngology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
,
Sameep Kadakia
2   Department of Plastic and Reconstructive Surgery, Wright State University, Dayton, Ohio
,
Yadranko Ducic
3   Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
29 November 2019 (online)

Abstract

Despite the generous blood supply, and resultant healing capacity within the head and neck, complex wounds in this area may be extremely debilitating and present an obstacle to treatment for the reconstructive surgeon. Delayed, incomplete, or otherwise suboptimal wound healing within this anatomical region may lead to both functional and aesthetically displeasing outcomes, resulting in impaired speech or swallowing, social stigma, and, in severe cases, exposure of critical underlying structures. Due to implications, with regard to wound formation following surgical intervention, the facial reconstructive surgeon, in particular, must be familiar with the multitude of treatment modalities available. This article serves as a review of the underlying pathophysiology of wound healing, local and systemic processes that may influence the healing process, and treatments that facilitate tissue restoration while mitigating future complications.

 
  • References

  • 1 Singer AJ, Clark RA. Cutaneous wound healing. N Engl J Med 1999; 341 (10) 738-746
  • 2 Furie B, Furie BC. Mechanisms of thrombus formation. N Engl J Med 2008; 359 (09) 938-949
  • 3 Robson MC, Steed DL, Franz MG. Wound healing: biologic features and approaches to maximize healing trajectories. Curr Probl Surg 2001; 38 (02) 72-140
  • 4 Redd MJ, Cooper L, Wood W, Stramer B, Martin P. Wound healing and inflammation: embryos reveal the way to perfect repair. Philos Trans R Soc Lond B Biol Sci 2004; 359 (1445): 777-784
  • 5 Eming SA, Krieg T, Davidson JM. Inflammation in wound repair: molecular and cellular mechanisms. J Invest Dermatol 2007; 127 (03) 514-525
  • 6 Winter GD, Scales JT. Effect of air drying and dressings on the surface of a wound. Nature 1963; 197: 91-92
  • 7 Levenson SM, Geever EF, Crowley LV, Oates III JF, Berard CW, Rosen H. The healing of rat skin wounds. Ann Surg 1965; 161: 293-308
  • 8 Schultz GS, Sibbald RG, Falanga V. , et al. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen 2003; 11 (Suppl. 01) S1-S28
  • 9 Falanga V. Classifications for wound bed preparation and stimulation of chronic wounds. Wound Repair Regen 2000; 8 (05) 347-352
  • 10 Bergstrom N, Allman RM, Alvarez OM. , et al. Treatment of pressure ulcers: clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; 1994
  • 11 Sibbald RG, Williamson D, Orsted HL. , et al. Preparing the wound bed--debridement, bacterial balance, and moisture balance. Ostomy Wound Manage 2000; 46 (11) 14-22 , 24–28, 30–35, quiz 36–37
  • 12 Hebda PA, Lo C. Biochemistry of wound healing: the effects of active ingredients of standard debriding agents—papain and collagenase—on digestion of native and denatured collagenous substrates, fibrin, and elastin. Wounds 2007; 13: 190-194
  • 13 Robson MC, Stenberg BD, Heggers JP. Wound healing alterations caused by infection. Clin Plast Surg 1990; 17 (03) 485-492
  • 14 Shokri T, Lighthall JG. Antibiotic use in facial plastic surgery. Curr Opin Otolaryngol Head Neck Surg 2018; 26 (04) 242-247
  • 15 Winter GD. Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. Nature 1962; 193: 293-294
  • 16 Brown CD, Zitelli JA. Choice of wound dressing and ointments. In: Hom DB, Hebda PA, Gosain AK, Friedman CD. , eds. Essential Tissue Healing of the Face and the Neck. Shelton, CT: PMPH and BC Decker; 2009: 224-238
  • 17 Pitzer GB, Patel KG. Proper care of early wounds to optimize healing and prevent complications. Facial Plast Surg Clin North Am 2011; 19 (03) 491-504
  • 18 Han G, Ceilley R. Chronic wound healing: a review of current management and treatments. Adv Ther 2017; 34 (03) 599-610
  • 19 Mooney EK, Lippitt C, Friedman J. Plastic Surgery Educational Foundation DATA Committee. Silver dressings. Plast Reconstr Surg 2006; 117 (02) 666-669
  • 20 Stanford W, Rappole BW, Fox Jr CL. Clinical experience with silver sulfadiazine, a new topical agent for control of pseudomonas infections in burns. J Trauma 1969; 9 (05) 377-388
  • 21 Atiyeh BS, Costagliola M, Hayek SN, Dibo SA. Effect of silver on burn wound infection control and healing: review of the literature. Burns 2007; 33 (02) 139-148
  • 22 Khundkar R, Malic C, Burge T. Use of Acticoat dressings in burns: what is the evidence?. Burns 2010; 36 (06) 751-758
  • 23 Yin HQ, Langford R, Burrell RE. Comparative evaluation of the antimicrobial activity of ACTICOAT antimicrobial barrier dressing. J Burn Care Rehabil 1999; 20 (03) 195-200
  • 24 Wright JB, Lam K, Burrell RE. Wound management in an era of increasing bacterial antibiotic resistance: a role for topical silver treatment. Am J Infect Control 1998; 26 (06) 572-577
  • 25 Huang Y, Li X, Liao Z. , et al. A randomized comparative trial between Acticoat and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007; 33 (02) 161-166
  • 26 Lam PK, Chan ESY, Ho WS, Liew CT. In vitro cytotoxicity testing of a nanocrystalline silver dressing (Acticoat) on cultured keratinocytes. Br J Biomed Sci 2004; 61 (03) 125-127
  • 27 Supp AP, Neely AN, Supp DM, Warden GD, Boyce ST. Evaluation of cytotoxicity and antimicrobial activity of Acticoat Burn Dressing for management of microbial contamination in cultured skin substitutes grafted to athymic mice. J Burn Care Rehabil 2005; 26 (03) 238-246
  • 28 Hansen SL, Voigt DW, Wiebelhaus P, Paul CN. Using skin replacement products to treat burns and wounds. Adv Skin Wound Care 2001; 14 (01) 37-44 , quiz 45–46
  • 29 Smith Jr DJ. Use of Biobrane in wound management. J Burn Care Rehabil 1995; 16 (3 Pt 1): 317-320
  • 30 Jones I, Currie L, Martin R. A guide to biological skin substitutes. Br J Plast Surg 2002; 55 (03) 185-193
  • 31 Balasubramani M, Kumar TR, Babu M. Skin substitutes: a review. Burns 2001; 27 (05) 534-544
  • 32 Noordenbos J, Doré C, Hansbrough JF. Safety and efficacy of TransCyte for the treatment of partial-thickness burns. J Burn Care Rehabil 1999; 20 (04) 275-281
  • 33 Hansbrough JF, Mozingo DW, Kealey GP, Davis M, Gidner A, Gentzkow GD. Clinical trials of a biosynthetic temporary skin replacement, Dermagraft-Transitional Covering, compared with cryopreserved human cadaver skin for temporary coverage of excised burn wounds. J Burn Care Rehabil 1997; 18 (1 Pt 1): 43-51
  • 34 Lineen E, Namias N. Biologic dressing in burns. J Craniofac Surg 2008; 19 (04) 923-928
  • 35 Johnson A, Gyurdieva A, Dhall S, Danilkovitch A, Duan-Arnold Y. Understanding the impact of preservation methods on the integrity and functionality of placental allografts. Ann Plast Surg 2017; 79 (02) 203-213
  • 36 Pourmoussa A, Gardner DJ, Johnson MB, Wong AK. An update and review of cell-based wound dressings and their integration into clinical practice. Ann Transl Med 2016; 4 (23) 457
  • 37 Supp DM, Boyce ST. Engineered skin substitutes: practices and potentials. Clin Dermatol 2005; 23 (04) 403-412
  • 38 Banwell PE. Topical negative pressure therapy in wound care. J Wound Care 1999; 8 (02) 79-84
  • 39 Argenta LC, Morykwas MJ, Marks MW, DeFranzo AJ, Molnar JA, David LR. Vacuum-assisted closure: state of clinic art. Plast Reconstr Surg 2006; 117 (7, Suppl): 127S-142S
  • 40 Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 1997; 38 (06) 563-576 , discussion 577
  • 41 Hunt TK, Linsey M, Grislis H, Sonne M, Jawetz E. The effect of differing ambient oxygen tensions on wound infection. Ann Surg 1975; 181 (01) 35-39
  • 42 Uhl E, Sirsjö A, Haapaniemi T, Nilsson G, Nylander G. Hyperbaric oxygen improves wound healing in normal and ischemic skin tissue. Plast Reconstr Surg 1994; 93 (04) 835-841
  • 43 Thom SR. Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg 2011; 127 (Suppl. 01) 131S-141S
  • 44 Kranke P, Bennett M, Roeckl-Wiedmann I, Debus S. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev 2004; 2 (02) CD004123
  • 45 Abidia A, Laden G, Kuhan G. , et al. The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers: a double-blind randomised-controlled trial. Eur J Vasc Endovasc Surg 2003; 25 (06) 513-518
  • 46 Da Costa RM, Ribeiro Jesus FM, Aniceto C, Mendes M. Randomized, double-blind, placebo-controlled, dose- ranging study of granulocyte-macrophage colony stimulating factor in patients with chronic venous leg ulcers. Wound Repair Regen 1999; 7 (01) 17-25
  • 47 Hom DB, Manivel JC. Promoting healing with recombinant human platelet-derived growth factor--BB in a previously irradiated problem wound. Laryngoscope 2003; 113 (09) 1566-1571