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Related Concept Videos

Phases of Wound Repair01:28

Phases of Wound Repair

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Following injury, the integrity of the injured tissues must be reestablished. For example, in skin tissue, wound repair involves coordination among resident skin cells, blood mononuclear cells, extracellular matrix, growth factors, and cytokines to complete the healing cascade.
Formation of Blood Clot
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Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
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Epidermal stem cells (EpiSCs) are mainly located at the basal layer of the epidermis. These cells repair minor injuries of the skin and replace dead skin cells. However, EpiSCs’ cannot heal severe wounds such as major burns or those from diabetes or hereditary disorders. In such cases, culturing the epidermal stem cells from the patient is possible and has yielded successful treatment options, such as laboratory-grown skin grafts. These grafts are synthesized using a patient’s own...
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A Case Series of Successful Abdominal Closure Utilizing a Novel Technique Combining a Mechanical Closure System with a Biologic Xenograft that Accelerates Wound Healing
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Primary skin closure after damage control laparotomy.

M J Pommerening1, L S Kao, K J Sowards

  • 1Department of Surgery, University of Texas Medical School at Houston, Houston, Texas, USA; Center for Translational Injury Research, University of Texas Medical School at Houston, Houston, Texas, USA; Center for Surgical Trials and Evidence Based Practice, University of Texas Medical School at Houston, Houston, Texas, USA.

The British Journal of Surgery
|November 14, 2014
PubMed
Summary
This summary is machine-generated.

Primary skin closure after damage control laparotomy (DCL) may increase surgical-site infection (SSI) risk. However, it can spare patients the morbidity of open wound management at discharge.

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Area of Science:

  • Trauma Surgery
  • Surgical Site Infections
  • Abdominal Surgery

Background:

  • Damage control laparotomy (DCL) is a critical intervention for severe traumatic injuries.
  • DCL is associated with significant patient morbidity and potential for surgical-site infections (SSI).
  • The management of the abdominal wall following DCL, specifically skin closure, requires careful consideration.

Purpose of the Study:

  • To investigate the association between primary skin closure and the risk of SSI after DCL.
  • To compare outcomes of primary skin closure versus secondary intention healing for abdominal wounds in DCL patients.

Main Methods:

  • Retrospective institutional review of 510 patients undergoing DCL (2004-2012).
  • Comparison of outcomes between primary skin closure and secondary wound healing groups.
  • Propensity score-adjusted multivariable logistic regression analysis to evaluate SSI risk.

Main Results:

  • Primary skin closure was performed in 111 patients (36.9%) and secondary healing in 190 patients (63.1%).
  • Multivariable analysis revealed primary skin closure was associated with an increased risk of abdominal SSI (P=0.020).
  • No significant association was found between primary skin closure and fascial dehiscence (P=0.446).

Conclusions:

  • Primary skin closure after DCL may be appropriate in select cases.
  • A potential increased risk of abdominal surgical-site infection exists with primary skin closure.
  • Further research may refine patient selection for primary skin closure to balance benefits and risks.