ABC of wound healing : Traumatic & surgical wounds
- By: David J Leaper, Keith G Harding
Management of traumatic and surgical wounds has had a chequered history. For example, in 1346 at the Battle of Crécy, France, foot soldiers were issued with cobwebs to staunch haemorrhage caused by trauma. Two centuries later, the eminent surgeon Ambroise Paré (1510-1590) rejected boiling oil as a primary dressing after amputation, preferring a mixture of oil of turpentine, rosewater, and egg.
Surgical incisions—Surgical incisions cause minimal tissue damage. They are made with precision in an environment where aseptic and antiseptic techniques reduce the risk of infection, with the best of instruments and the facility to control haemostasis. Penetrating trauma may involve minimal damage to skin and connective tissue, though deeper damage to vessels, nerves, and internal organs may occur.
Lacerations—Lacerations are caused when trauma exceeds intrinsic tissue strength—for example, skin torn by blunt injury over a bony prominence such as the scalp. Tissue damage may not be extensive, and primary