Prepared by : Dr. Bareka Salah Normal Wound Healing Prepared by : Dr. Bareka Salah

Wound closure: Primary closure Delayed primary closure Secondary closure Tertiary Phase of Wound Healing: Inflammatory Proliferative phase Remodeling phase

Chronic Wound

Chronic Wound

Factors contributing to impaired wound healing A. Local factors B. Systemic factors Arterial insufficiency Venus insufficiency Edema Infection Pressure Radiation Foreign material Necrotic tissue DM Malnutrition Vitamin deficiency Chemotherapy Smoking Aging Steroids

Excessive Wound Healing Keloids Hypertrophic scars

Etiology Histology Treatment Surgical excision Z-Plasty W-Plasty Steroids Silicon Pressure garment Laser Interferon

Frostbite

Trench foot

Predisposing risk factors Classification Pathopgysiology

Treatment Systematic antiprostaglandin agent Re-warming T.T Analgesia Dressing Massaging X Amputation Antibiotics X Adjuvant therapy: alpha blocker, free radical scavengers, thrombolytics Steroids X Debridement Elevation Late sequelae. Topical thromboxane inhibitor