1. RCS 6080 Medical and Psychosocial Aspects of Rehabilitation Counseling Wound Healing & Plastic Surgery

2. Wounds  Any breach in the surface of the body or any tissue disruption produced by the application of energy  Usually physical injury  Abrasion, degloving injury  Contusion, crush injury  Incision, laceration

3. Skin content refresher

4. Wound Healing  As wound heals: –Fluid and cells drain from damaged tissue –Exudate may be:  Clear  Bloody  Pus-containing  Proper wound healing: –Cleanliness and care of lesion –Proper circulation –Good general health and nutrition

5. Phases of healing  Inflammatory –Bleeding/clotting –Migration of WBCs –Cell swelling  Reparative –Laying down of collagen + migration of epith. cells –New capillary loops –Proliferation of fibroblastsstrands of collagen  Consolodative –reorientation +contraction of collagen –collagen synthesisdegradation – vascularity

6. Complications  Hypertrophic scar = continued production of collagen  Keloid = ….with extension into surrounding tissues  Scar contracture

7. Plastic surgery  Scar Revision –Laser resurfacing/dermabrasion –Z-plasty –Skin-grafting/flap surgery –Tissue expansion