In surgical speciality, understanding of the wound healing is absolutely necessary. There are different kinds of wounds that require treatment which is most appropriate to them. In this chapter, we have discussed treatment for different types of wounds in four main types according to WHO Classification. Pros and cons of different types of materials used for cleaning and dressing are discussed. Dressing materials are discussed in detail. We have described the process of wound healing. There are various factors that influence wound healing and we have specifically described how they differ in primary and secondary wound healing. Usage of various kinds of dressing materials and their mechanism of action is described in detail. We have specifically highlighted the role of community nurses and tissue viability nurses. Since the availability and the recognition of tissue viability nurses, the cost of wound treatment has come down considerably and it is also very popular with the patients. Vacuum-assisted closure (VAC) therapy is very helpful in large wounds that are producing a lot of exudates. The VAC pulls the skin edges together and removes the exudate. Other adjunctive therapies are also mentioned but they are not available in most hospitals and therefore detailed descriptions are not provided.
Part of the book: Wound Healing
This chapter will focus on the subject of tissue regeneration in a variety of different surgical fields and operations. We will explore the use of acellular dermal matrices, stem cell-based therapies, gene regulation, emerging 3D printing techniques and their potential applications in surgery. Acellular dermal matrices (ADMs) are biological materials derived from human or animal tissue through complicated and expensive decellularisation processes, leading to acellular material that can be used to aid tissue healing. ADMs were first introduced for the treatment of burn injuries, but are now widely used in a variety of surgical fields, including abdominal wall and breast reconstruction. A wide range of materials can be used to produce ADMs, but usually include bovine, porcine or human tissues (e.g., dermis and pericardium). ADMs act as scaffolds onto which human tissue can incorporate, allowing for an innovative, yet a very effective way to aid tissue regeneration. Stem cell therapies also hold promise in aiding tissue regeneration in the coming years and we will also explore techniques that are currently being researched by prominent scientists all across the world. For example, adipose tissue-derived stem cells (ASCs) are a potentially revolutionary therapy in regenerative medicine. We will review the current evidence available and consider the possible clinical applications of ASCs, including their potential to treat ischaemic diseases and their role in healing chronic wounds. ASCs are adult stem cells, which display similar morphology and differentiation properties to adult mesenchymal stem cells (MSCs). The multiple linage pathways displayed by ASCs allows a variety of tissues to be repaired and maintained. Moreover, adipose tissue is abundant, easily accessible and is able to be repeatedly harvested with low morbidity. Previously, autologous fat grafting was more commonly utilised for managing volume defects in reconstructive and plastic surgery; however, recent literature has revealed promising therapeutic effects of ASCs in tissue regeneration. Finally, gene regulation, which holds promise in musculoskeletal diseases, and 3D printed scaffolds that aid neural regeneration will also be discussed in this chapter as emerging, and potentially very promising, tissue regeneration techniques.
Part of the book: Tissue Regeneration