Surgical wound healing and management

198 Pages·2012·8.948 MB·English

by  Granick, Mark S., Téot, Luc

Surgical Wound
Healing and
Management
Second Edition
Edited by
Mark S. Granick
Luc Téot
Surgical Wound Healing
and Management

Surgical Wound Healing
and Management
Second Edition
Mark S. Granick, MD, FACS
Chief, Division of Plastic Surgery,
New Jersey Medical School-UMDNJ,
Newark, New Jersey, USA
Luc Téot, MD, PhD
Associate Professor of Plastic Surgery,
Wound Healing and Burns,
Montpellier University Hospital,
Montpellier, France
Published in 2012 by Informa Healthcare, 119 Farringdon Road, London EC1R 3DA, UK.
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Contents
Contributors vii
Preface ix
1. The physiology of wound bed preparation 1
Gregory S. Schultz
2. Wound surgery 18
Mark S. Granick and Luc Téot
3. Surgical management of necrotizing fasciitis 26
Tristan L. Hartzell and Dennis P. Orgill
4. Debridement of acute traumatic wounds (avulsion, crush, and high powered) 36
Michael Suk
5. Burn surgery 49
Malachy E. Asuku and Stephen M. Milner
6. Skin grafts in wound management 58
Lars-Peter Kamolz and Raymund E. Horch
7. Alternatives to skin grafts 66
Franck Duteille and Luc Téot
8. Timing of reconstruction 75
Naveen K. Ahuja and James M. Russavage
9. The infl uence of negative pressure wound therapy on wound surgery 84
Ravi K. Garg and Geoffrey C. Gurtner
10. The clinical use of negative pressure wound therapy with instillation in
surgical wound healing 94
Tom Wolvos
11. Debridement of infected orthopedic prostheses 100
John S. Davidson, Eugene M. Toh and Tom Wolvos
12. Management of surgical site infections 110
David Leaper and Donald Fry
13. Surgical management of venous leg ulcers 120
Dieter Mayer
14. Surgical management of diabetic foot ulcers 128
Joseph L. Fiorito, Brian Leykum, and D.G. Armstrong
15. Surgical management of pressure ulcers 143
Sadanori Akita
16. Incorporating advanced wound therapies into the surgical
wound management strategy 155
William J. Ennis, Claudia Lee, Malgorzata Plummer, Audrey Sui, and Patricio Meneses
VI CONTENTS
17. Evolution of telemedicine in plastic and reconstructive surgery 163
M. Trovato, M. Granick, L. Téot, and H. Kaufman
18. Wound dressings for surgeons 171
Sylvie Meaume and Isabelle Weber
Index 181
Contributors
Naveen K. Ahuja Geoffrey C. Gurtner
University of Pittsburgh Medical Center Stanford University School of Medicine,
Pittsburgh, Pennsylvania, USA Stanford, California, USA
Sadanori Akita Tristan L. Hartzell
Department of Plastic and Reconstructive Faith Regional Health System,
Surgery, Nagasaki University Hospital Norfolk, Nebraska, USA
Sakamoto, Nagasaki, Japan
Raymund E. Horch
D.G. Armstrong Department of Plastic and Hand Surgery,
Southern Arizona Limb Salvage Alliance University of Erlangen Medical Center,
(SALSA), University of Arizona College Krankenhausstr, Erlangen, Germany
of Medicine, Tucson, Arizona, USA
Lars-Peter Kamolz
Malachy E. Asuku Section of Plastic, Aesthetic and
Johns Hopkins University School of Reconstructive Surgery, Department of
Medicine, Michael D. Hendrix Burn Surgery, State Hospital Wiener Neustadt,
Research Center, Baltimore, Maryland, USA Austria
Hanna Kaufman
Franck Duteille
Wound Healing Unit Maccabi Healthcare
Service de Chirurgie Plastique Reconstruc-
Services, Haifa, Israel
trice et Esthétique, Centre des Brûlés
Immeuble Jean Monnet, Centre Hospitalier
Professor David Leaper
Universitaire, Nantes Cedex, France
Newcastle University, Newcastle upon
Tyne, United, Kingdom
William J. Ennis
Imperial College, London, United Kingdom
University of Illinois Medical Center,
James Hospital and Healthcare Centers,
Claudia Lee
Olympia Fields Campus, Olympia Fields,
St. James Hospital and Healthcare Centers,
Illinois, USA
Olympia Fields Campus, Olympia Fields
Illinois, USA
Joseph L. Fiorito
Southern Arizona Limb Salvage Alliance
Brian Leykum
(SALSA), University of Arizona College of
Southern Arizona Limb Salvage Alliance
Medicine, Tucson, Arizona, USA
(SALSA), University of Arizona College of
Medicine, Tucson, Arizona, USA
Professor Donald Fry
University of New Mexico School of Dieter Mayer
Medicine, Adjunct Professor of Surgery,
University Hospital of Zurich
Northwestern University,
Zurich, Switzerland
Chicago, Illinois, USA
Sylvie Meaume
Ravi K. Garg AP-HP Rothschild Hospital
Stanford University School of Medicine, Paris, France
Stanford, California, USA
Stephen M. Milner
Mark S. Granick Johns Hopkins Burn Center, Johns Hopkins
Chief, Division of Plastic Surgery, University School of Medicine, Baltimore,
New Jersey Medical School-UMDNJ Maryland, USA
New Jersey, USA
VIII CONTRIBUTORS
Johns Hopkins Wound Healing Center, Luc Téot
Baltimore, Maryland, USA Wound Healing Unit, Hôpital Lapeyronie,
Montpellier cedex, France
Michael D. Hendrix Burn Research Center,
Baltimore, Maryland, USA
Matthew Travato
Dallas Plastic Surgery Institute,
Dennis P. Orgill
Dallas, Texas, USA
Division of Plastic Surgery,
Brigham and Women’s Hospital,
Isabelle Weber
Boston, Massachusetts, USA
AP-HP Rothschild Hospital,
Paris, France
Malgorzata Plummer
University of Illinois Medical Center,
Tom Wolvos
Olympia Fields, Illinois, USA
Scottsdale Healthcare Osborn
Medical Center, Scottsdale,
James Russavage
Arizona, USA
University of Pittsburgh Medical Center,
Pittsburgh, Pennsylvania, USA
John S. Davidson
Lower Limb Arthroplasty Unit,
Gregory S. Schultz
The Royal Liverpool and Broadgreen
Department of Obstetrics and Gynecology,
University Hospitals, Liverpool, UK
Institute for Wound Research,
University of Florida, Gainesville,
Eugene M. Toh
Florida, USA
Lower Limb Arthroplasty Unit,
The Royal Liverpool and Broadgreen
Michael Suk
University Hospitals, Liverpool, UK
University of Florida Shands Jacksonville,
Jacksonville, Florida, USA
Preface
For the past 400 years, wound care has been managed by a wide variety of physicians and
medical professionals of different backgrounds. In general there is a medical approach and a
surgical approach to the treatment of wounds. For the past two decades both the editors,
Dr Granick and Dr Teot, have dedicated a considerable effort toward bringing the disparate
wound care philosophies together into a more coordinated endeavor. The advent of sophisti-
cated, but expensive, biologically active wound treatments and improved versatile technolo-
gies is a major driving force propelling the wound management consortium into a specialty of
its own. While it is critical for surgeons who treat wounds to know and understand about the
appropriate dressings and medical interventions, it is equally important for medically oriented
wound specialists to recognize when a patient will benefi t from surgery.
In compiling this second edition of Surgical Wound Management, Dr Teot has joined
Dr Granick as co-editor. Both editors are highly invested in wound care education. Dr Teot
developed a program in Europe dedicated to teaching a broad range of medical professionals
about emerging wound care technologies. He and Dr Granick have extended this program
worldwide. Both editors independently began telemedicine projects to facilitate wound man-
agement. They independently started different journals devoted to wound care and surgery.
Both editors have written and lectured extensively about their initiatives to educate all wound
care specialists in the full spectrum of available care options. In Europe, Dr Teot has developed
a university-endorsed diploma to certify a wound care training program. In the United States
and Canada, Dr Granick is working with a diverse group of wound specialists to create the
American Board of Wound Medicine and Surgery.
In this edition, we have brought together many of our close colleagues from all areas of the
world to share their surgical experience. The fi rst two chapters deal with the basic topics and
serve as the background for understanding the process of wound healing and the philosophy of
wound surgery. The debridement chapters cover rare and aggressive diseases such as necrotiz-
ing fasciitis, as well as common problems such as open fractures and burns. The tools of the
trade are then reviewed including skin grafting, various fl ap reconstructions, and negative pres-
sure wound therapy from a surgical perspective. Infectious issues are reviewed with regard to
surgical prostheses and surgical site infections. The surgical management of the major wound
disease categories is then approached with chapters on diabetic foot ulcers, venous leg ulcers,
and pressure ulcers. The role of advanced therapies in the surgeon’s armamentarium is then
discussed. The next chapter introduces the concept and use of telemedicine as applied to surgi-
cal wound management in three different countries. The fi nal chapter is an expert overview of
dressings, which is directed specifi cally at surgeons. This excellent summary highlights how an
effective and effi cient use of the wide range of dressing materials enhances surgical outcomes.
This edition is intended to update the wound surgery community on current develop-
ments in wound care and expose them to the excellent work being performed by their interna-
tional colleagues. We hope that this edition will additionally empower all medical professionals
who treat wounds to understand the effi cacy, utility, and role of surgery in wound management.
Mark S. Granick, MD, FACS
Newark, New Jersey, USA
Luc Téot, MD, PhD
Montpellier, France