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Chapter-02 Wound Healing

BOOK TITLE: Sataloff's Comprehensive Textbook of Otolaryngology: Head & Neck Surgery (Facial Plastic and Reconstructive Surgery) - Volume 3

Author
1. Teti Virginia P
2. Most Sam P
ISBN
9789351524595
DOI
10.5005/jp/books/12699_3
Edition
1/e
Publishing Year
2016
Pages
12
Author Affiliations
1. Stanford University School of Medicine, Stanford, California, USA
2. Stanford University School of Medicine, Stanford, California, USA
Chapter keywords
wound healing, epidermis, dermis, overlying papillary portion, deeper reticular layer, Dermal collagen, hemostasis, inflammation, proliferation, remodeling, fibrin clot, Vitamin C deficiency, hydroxylation, proline, lysine, collagen synthesis

Abstract

This chapter discusses wound healing, where epidermis overlies the dermis and provides a protective, waterproof covering characterized by its color, quality, texture and scar tissue. Beneath the epidermis lies the dermis, fashioned into two layers, such as an overlying papillary portion and deeper reticular layer. Dermal collagen provides strength and extensibility of the skin, whereas elastic fibers provide recoil for the skin. The mechanisms of wound healing are described in four basic phases, which are hemostasis, inflammation, proliferation and remodeling. The hemostatic and inflammatory phases involve platelet aggregation on a fibrin clot leading to hemostasis followed by migration of inflammatory cells to remove debris allowing a favorable environment for repair. Maturation or remodeling phase involves a dynamic balance between collagen production and degradation. Primary wound healing involves meticulous reapproximation of full-thickness wound edges via tape, suture, staples, or graft. Vitamin C deficiency prevents the hydroxylation of proline and lysine, thereby significantly impairing collagen synthesis.

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