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Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



Normal wound healing

Learning objectives
Introduction
Epidermal repair
Dermal repair
Moist wound healing
Activity

Learning objectives

Introduction

Skin generally heals rapidly to restore barrier function after injuries such as cuts, abrasions, thermal burns, puncture wounds and blisters.

The severity of a wound depends on its surface area and depth. Partial thickness wounds can recruit new keratinocytes from adjacent adnexal tissue and can regenerate much more rapidly than full thickness wounds of the same surface area where regeneration of epithelium arises only from keratinocytes on the wound edges. Damage to the dermis can be repaired but results in altered tissue i.e. a scar. However, fetal wounds heal by regeneration without fibrosis so do not result in scars.

Injury results in epidermal and dermal repair:

Haemostasis creates a protective wound scab beneath which cell migration and movement of the wound edges can occur.
Inflammation brings nutrients to the area of the wound, removes debris and bacteria, and provides chemical stimuli for wound repair.
Repair begins immediately after wounding and proceeds rapidly through the processes of epithelialisation, fibroplasia, and capillary proliferation into the healing area.

Wounds can be classified as either acute or chronic. Acute wounds are sometimes defined as those that follow the normal phases of healing; they are expected to show signs of healing in less than 4 weeks and include postoperative wounds. Chronic wounds are those that persist for longer than 4 weeks and are often of complex poorly understood origin.

Acute surgical wound
Acute surgical wound:
curettage pyogenic granuloma
Chronic pressure ulcer
Chronic pressure ulcer
Healing venous ulcer
Healing venous ulcer:
granulation tissue
Wounds

Epidermal repair

Dermal repair

Moist wound healing

A moist environment is beneficial compared with a dry wound. Moist wounds:

Activity

Describe typical acute and chronic wounds seen in your clinic recently.

 

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Author: Hon Assoc Prof Amanda Oakley

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