[The physiology of wound healing]

Wound healing is a complex biological phenomenon. A variety of cellular and biochemical events take place designed to achieve tissue integrity following injury. Even though hypoxia caused by the damaged microvasculature is an important initial stimulus of the healing cascade, adequate tissue perfusion and oxygenation is an absolute pre-requisite for a successful repair since essential wound healing mechanisms such as collagen deposition and bactericidal defence are oxygen dependent reactions. Based upon these findings, there are several ways to overcome the obstacle of tissue hypoxia in clinical practice. Supplemental oxygen is capable of increasing tissue oxygen tension. Following surgery, pain, cold and to little fluids are the main issues of vasoconstriction, impaired tissue perfusion and oxygenation as well. However, all these parameters must be corrected at the same time because any one is sufficient to cause maximal vasoconstriction. A well hydrated, pain free and warm patient should be the main goal of peri- and postoperative surgical care.