Dehiscence and Necrosis

  • Ross M. Campbell
  • Raymond G. DufresneJr.


Wound healing is comprised of a complex cycle of inflammation, proliferation, and remodeling. Vast numbers of cellular growth factors, cytokines, and cell types are involved. Recent research has provided new information that may enable clinicians to improve wound healing in the future. Although there is currently a wealth of knowledge about the science of wound healing, the incidence of acute wound failure has not decreased significantly in the last 75 years.1


Wound Healing Wound Dehiscence Impair Wound Healing Topical Antibiotic Cushing Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Wassermann RJ, Polo M, Smith PD, et al. Differential production of apoptosis modulating proteins in patients with hypertrophic burn scar. J Surg Res 1998;75:74–79.CrossRefPubMedGoogle Scholar
  2. 2.
    Dubay DA, Franz MG. Acute wound healing: the biology of acute wound failure. Surg Clin North Am 2003;83:463–481.CrossRefPubMedGoogle Scholar
  3. 3.
    Fine NA, Mustoe TA. Wound Healing. In: Greenfield LJ, Mulholland MW, Oldham KT, Zelenock GB, Lillemow KD, eds. Surgery: scientific principles and practice. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001:69–87.Google Scholar
  4. 4.
    Morgan CJ, Pledger WJ. Fibroblast proliferation. In: Cohen IH, Diegelmann RF, Lindblad WJ, eds. Wound healing: biochemical and clinical aspects. Philadelphia: Saunders; 1991:63–76.Google Scholar
  5. 5.
    Madden JW, Peacock EE. Studies on the biology of collagen during wound healing: I. Rate of collagen synthesis and deposition in cutaneous wounds of the rat. Surgery 1968;64:288.PubMedGoogle Scholar
  6. 6.
    LaVan FB, Hunt TK. Oxygen and wound healing. Clin Plast Surg 1990;17:463.PubMedGoogle Scholar
  7. 7.
    Jonsson K, Jensen JA, Goodson WH 3rd, et al. Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients. Ann Surg 1991;214:6.CrossRefGoogle Scholar
  8. 8.
    Dufresne RG. Surgical complication: prevention, recognition, and treatment. In: Ratz JL, ed. Textbook of dermatologic surgery. Philadelphia: Lippincott-Raven; 1998:59–63.Google Scholar
  9. 9.
    Koyama H, Isshiki N, Noda R, Nishimura R. Long-term survival of a split-thickness skin graft on a large seroma. Plast Reconstr Surg 1987;79:110–113.CrossRefGoogle Scholar
  10. 10.
    Salasche SJ. Acute surgical complications: cause, prevention, and treatment. J Am Acad Dermatol 1986;15:1163–1185.CrossRefPubMedGoogle Scholar
  11. 11.
    Levenson SM, Demetriou AA. Metabolic factors. In: Cohen IH, Diegelmann RF, Lindblad WJ, eds. Wound healing: biochemical and clinical aspects. Philadelphia: Saunders; 1991:248–273.Google Scholar
  12. 12.
    Lawrence C. Drug management in skin surgery. Drugs 1996;52:805–817.CrossRefPubMedGoogle Scholar
  13. 13.
    Hogstrom H, Haglund U, Zederfeldt B. Tension leads to increased neutrophil accumulation and decreased laparotomy wound strength. Surgery 1990;107:215–219.PubMedGoogle Scholar
  14. 14.
    Rappaport WD, Hunter GC, Allen R, et al. Effect of electrocautery on wound healing in midline laparatomy incisions. Am J Surg 1991;160:618–620.CrossRefGoogle Scholar
  15. 15.
    Riou JP, Cohen JR, Johnson H. Factors influencing wound dehiscence. Am J Surg 1992;163:324–330.CrossRefPubMedGoogle Scholar
  16. 16.
    Angel MF, Narayanan, Swartz WM, et al. The etiologic role of free radicals in hematoma-induced flap necrosis. Plastic Reconstr Surg 1986;77:795–803.CrossRefGoogle Scholar
  17. 17.
    Diaz DD, Freeman SB, Wilson JF, Parker GS. Hematoma-induced flap necrosis and free radical scavengers. Arch Otolaryngol Head Neck Surg 1992;118:516–518.PubMedGoogle Scholar
  18. 18.
    Doughty DB. Preventing and managing surgical wound dehiscence. Home Health Nurse 2004;22:364–367.CrossRefGoogle Scholar
  19. 19.
    Khachemoune A, Krejci-Papa N, Finn DT, Rogers GS. Dehisced clean wound: resuture it or steri-stip it? Dermatol Surg 2004;30:431–432.CrossRefPubMedGoogle Scholar
  20. 20.
    Krueger JK, Rohrich RJ. Clearing the smoke: the scientific rationale for tobacco abstention with plastic surgery. Plast Reconstr Surg 2001;108:1063–1073.CrossRefPubMedGoogle Scholar
  21. 21.
    Wong LS, Martins-Green M. Firsthand cigarette smoke alters fibroblast migration and survival: implications for impaired healing. Wound Repair Regen 2004;12:471–484.CrossRefPubMedGoogle Scholar
  22. 22.
    Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250–257.CrossRefPubMedGoogle Scholar
  23. 23.
    Dire DJ, Coppola M, Dwyer DA, Lorette JJ, Karr JL. Prospective evaluation of topical antibiotics for preventing infections in uncomplicated soft-tissue wounds repaired in the ED. Acad Emerg Med 1995;2:4–10.CrossRefPubMedGoogle Scholar
  24. 24.
    Mackway-Jones K. Towards evidence based emergency medicine: best BETs from Manchester Royal Infirmary. Emerg Med J 2002;19:550–557.CrossRefGoogle Scholar
  25. 25.
    Smack DP, Harrington AC, Dunn C, et al. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. A randomized controlled trial. JAMA 1996;276:972–977.CrossRefPubMedGoogle Scholar
  26. 26.
    Campbell RM, Perlis CS, Fisher E, Gloster HM. Gentamycin ointment versus petrolatum for management of auricular wounds. Dermatol Surg 2005;31:664–669.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Ross M. Campbell
    • 1
  • Raymond G. DufresneJr.
    • 2
  1. 1.Total Skin and Beauty Dermatology CenterBirminghamUSA
  2. 2.Department of Dermatology, Brown Medical SchoolRhode Island HospitalProvidenceUSA

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