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Wound healing
Clin Plastic Surg 30 (2003) ix
Preface
Wound healing
Linda G. Phillips, MD, FACS Guest Editor
As plastic surgeons, optimal wound healing is critically important to our clinical outcome. We are expected to be able to heal patients without leaving scars. Although we are ourselves aware that this is an impossible goal, we nevertheless strive to achieve a scar that is minimally apparent. Our attempt to prevent proliferative scars in our own postoperative patients is balanced by the attempt to achieve improved scar formation in those failed wound-healing attempts that are referred to us by our colleagues in other surgical disciplines. We attempt both nonoperative and operative means to manipulate the wound and achieve closure. A healed wound is the sine qua non of surgical care. Sometimes we must perform tissue transfers with local or distant flaps to achieve this end, which always results in a donor site deformity. We know that if we could somehow manipulate the patient to create new tissue or generate the lost part, we could achieve an end that more resembles the preinjury or presurgical appearance and function without the donor site morbidity. With these principles in mind, this issue of Clinics in Plastic Surgery begins with a thorough discussion of normal wound-healing processes. Fetal wound healing, with its scarless result, remains the Tantalus for clinicians. Errors in wound healing, due to local infection, systemic disease, or other impairments,
sometimes can be anticipated and always must be understood in order to achieve some control. Whether our intervention involves surgery, systemic disease control, the use of modalities such as hyperbaric oxygen, or local antibody or cytokine therapy, we can impact the repair process for our patients. The treatments discussed in this issue are cutting edge. Also discussed is tissue engineering—not just regenerating tissue, but actually creating it, using Star Wars technology—which is the hope for the future. All of these interventions require extensive knowledge of wound healing: what the process involves, what comorbidities can impact the result, and where and how physicians may intervene. This issue of Clinics in Plastic Surgery, with its superb articles written by my talented colleagues, will contribute to this knowledge. I am truly honored to have worked with each of these contributors and I hope that the readers will find that this issue contributes significantly to their knowledge of wound healing and their ability to achieve a better outcome for patients.
0094-1298/03/$ – see front matter D 2003, Elsevier Science (USA). All rights reserved. PII: S 0 0 9 4 - 1 2 9 8 ( 0 2 ) 0 0 0 8 9 - 5
Linda G. Phillips, MD, FACS Division of Plastic Surgery 6124 McCullough Building 301 University Blvd Galveston, TX 77555-0724, USA
Preface
Wound healing
Linda G. Phillips, MD, FACS Guest Editor
As plastic surgeons, optimal wound healing is critically important to our clinical outcome. We are expected to be able to heal patients without leaving scars. Although we are ourselves aware that this is an impossible goal, we nevertheless strive to achieve a scar that is minimally apparent. Our attempt to prevent proliferative scars in our own postoperative patients is balanced by the attempt to achieve improved scar formation in those failed wound-healing attempts that are referred to us by our colleagues in other surgical disciplines. We attempt both nonoperative and operative means to manipulate the wound and achieve closure. A healed wound is the sine qua non of surgical care. Sometimes we must perform tissue transfers with local or distant flaps to achieve this end, which always results in a donor site deformity. We know that if we could somehow manipulate the patient to create new tissue or generate the lost part, we could achieve an end that more resembles the preinjury or presurgical appearance and function without the donor site morbidity. With these principles in mind, this issue of Clinics in Plastic Surgery begins with a thorough discussion of normal wound-healing processes. Fetal wound healing, with its scarless result, remains the Tantalus for clinicians. Errors in wound healing, due to local infection, systemic disease, or other impairments,
sometimes can be anticipated and always must be understood in order to achieve some control. Whether our intervention involves surgery, systemic disease control, the use of modalities such as hyperbaric oxygen, or local antibody or cytokine therapy, we can impact the repair process for our patients. The treatments discussed in this issue are cutting edge. Also discussed is tissue engineering—not just regenerating tissue, but actually creating it, using Star Wars technology—which is the hope for the future. All of these interventions require extensive knowledge of wound healing: what the process involves, what comorbidities can impact the result, and where and how physicians may intervene. This issue of Clinics in Plastic Surgery, with its superb articles written by my talented colleagues, will contribute to this knowledge. I am truly honored to have worked with each of these contributors and I hope that the readers will find that this issue contributes significantly to their knowledge of wound healing and their ability to achieve a better outcome for patients.
0094-1298/03/$ – see front matter D 2003, Elsevier Science (USA). All rights reserved. PII: S 0 0 9 4 - 1 2 9 8 ( 0 2 ) 0 0 0 8 9 - 5
Linda G. Phillips, MD, FACS Division of Plastic Surgery 6124 McCullough Building 301 University Blvd Galveston, TX 77555-0724, USA