Wound healing and dermatologic dressings

Abstract

The problem of optimal wound healing is not a new one; however, much attention is now being focused on this, as witnessed by several recent reviews. 1–5 In addition, there has also been a similar focus on changes in the skin that modify optimal wound healing. It has been traditional to categorize healing by primary and secondary intent, and this is a part of the basic vocabulary and elementary education of any surgeon. More recently, this has become an increasingly familiar part of the practice of dermatology with its growing surgical emphasis. Indeed, the ultimate calling card for a successful surgeon is the patient's postoperative scar (or lack of same). The increase in surgical procedures performed by dermatologists has been part of the renewed impetus for research in wound healing in this specialty. Further, the immense public cost of slowly healing or nonhealing lesions (diabetic ulcers, decubitus ulcers, etc.) has further focused federal National Institutes of Health funding on the problem, increasing the support for the investigations. Because surgery is now an important part of daily practice of many dermatologists, an awareness of advances in this area has become essential. Advances in dermatologic dressings are having increasing impact in practice. They accelerate the healing process and in many instances provide a better cosmetic result. These new dressings are appropriate for wounds healing by both primary intent and secondary intent. Let us briefly review both processes and the indications for dressings.