Abstract
Background
Wound healing is a complex and dynamic process and a thorough knowledge of the basics of physiology of wound healing is a must to implement principles of chronic wound care. Understanding wound healing at multiple levels—biochemical, physiologic, cellular and molecular provides the surgeon with a framework for basing clinical decisions aimed at optimizing the healing response.
Objective
This review article describes the classification of wounds and aims to highlight the fundamentals of wound repair, enumerating the dressings used commonly and also, the newer concepts of wound healing.
Materials and methods
Search engines and medical databases were tapped to gather information on the subject. Search words employed were “Wounds”, “wounds in OSMF”, “Wound healing”, “Repair”, “Dressings in OMFS”.
Results
The search resulted in total of 153 articles which we reviewed to add to the literature the concepts of wound healing and to throw some light on recent advances in wound care.
Conclusions
Wound healing remains a challenging clinical problem and correct, efficient wound management is essential to positively influence the wound healing course and reduce potential complications.
Similar content being viewed by others
References
Mehra R (2002) Historical survey of wound healing. Bull Indian Inst Hist Med Hyderabad 32(2):159–175
Kerstein MD (1997) The scientific basis of healing. Adv Wound Care 10(3):30–36
Lazarus GS, Cooper DM, Knighton DR, Margolis DJ, Pecoraro RE, Rodeheaver G et al (1994) Definitions and guidelines for assessment of wounds and evaluation of healing. Arch Dermatol 130:489–493
Robson MC, Steed DL, Franz MG (2001) Wound healing: biologic features and approaches to maximize healing trajectories. Curr Probl Surg 38:72–140
Natarajan S, Williamson D, Stiltz AJ, Harding K (2000) Advances in wound care and healing technology. Am J Clin Dermatol 1:269–275
Alonso JE, Lee J, Burgess AR, Browner BD (1996) The management of complex orthopaedic injuries. Surg Clin N Am 76:879–903
Traversa B, Sussman G (2001) The role of growth factors, cytokines and proteases in wound management. Primary Intent 9(4):161–167
Sabiston DC (1991) Chap 10: Wound healing: biologic and clinical features. In: Sabiston DC (ed) Textbook of surgery, 14th edn. WB Saunders, Philadelphia. ISBN: 0-7216-3492-3
Sharma M, Khajja BS, Jha S, Mathur GK, Mathur VN (2011) Forensic interpretation of injuries/wounds found on the human body. J Punjab Acad Forensic Med Toxicol 11(2):105–109
Bischoff M, Kinzl L, Schmelz A (1999) The complicated wound. Unfallchirurg 102:797–804
Degreef H (1998) How to heal a wound fast. Dermatol Clin 16:365–375
Attinger CE, Janis JE, Steinberg J, Schwartz J, Al-Attar A, Couch K (2006) Clinical approach to wound debridement and wound bed preparation including the use of dressings and wound healing adjuvants. Plast Reconstr Surg 117(7 Suppl):72S–109S
CCHCS care guide: wound and skin ulcer management. Nov 2012
Chard R (2008) Wound classifications. Clinical issues. AORN J 88(1):108–109
Miloro M, Ghali GE, Larsen PE, Waite PD (2004) Chapter 1 Wound healing. In: Shetty V, Bertolami CN (eds) Peterson’s principles of oral and maxillofacial surgery, 2nd edn. BC Decker, Hamilton. ISBN: 1-55009-234-0
Kumar V, Abbas AK, Fausto N (2004) Robbins and Cotron Pathologic basis of disease, 7th edn. Saunders, Philadelphia, PA. ISBN: 0808923021
Rajagopal KS (2008) Manipal manual of surgery, 2nd edn. CBS Pullisher, New Delhi. ISBN: 978-81-239-1649-1
Peterson AS (2010) The “golden period” for wound repair. J Lanc Gen Hosp 5(4):134–135
Diegelmann RF, Evans MC (2004) Wound healing: an overview of acute fibrotic and delayed healing. Front Biosci 9:283–289
Werner S, Grose R (2003) Regulation of wound healing by growth factors and cytokines. Physiol Rev 83:835–870
Singer AJ, Clark RA (1999) Cutaneous wound healing. N Engl J Med 341:738–746
McGrath MH (1990) Peptide growth factors and wound healing. Clin Plast Surg 17:421–432
Steed D (1997) The role of growth factors in wound healing. Surg Clin N Am 77(3):575–586
Stadlemann W, Digenis A, Tobin G (1998) Physiology and healing dynamics of chronic cutaneous wounds. Am J Surg 176(Suppl 2A):26S–38S
Witte MB, Barbul A (1997) General principles of wound healing. Surg Clin N Am 77(3):509–528
Guo S, DiPietro LA (2010) Factors affecting wound healing: critical reviews in oral biology and medicine. J Dent Res 89(3):219–229
Jonsson K, Jensen JA, Goodson WH 3rd, Scheuenstuhl H, West J, Hopf HW et al (1991) Tissue oxygenation, anemia and perfusion in relation to wound healing in surgical patients. Ann Surg 214(5):605–613
Lavan FB, Hunt TK (1990) Oxygen and wound healing. Clin Plast Surg 17:463–472
Wu L, Xia YP, Roth SI, Gruskin E, Mustoe TA (1999) Transforming growth factor-beta1 fails to stimulate wound healing and impairs its signal transduction in an aged ischemic ulcer model: importance of oxygen and age. Am J Pathol 154(1):301–309
Hunt TK, Hopf HW (1997) Wound healing and wound infection. What surgeons and anesthesiologists can do. Surg Clin N Am 77:587–606
Suh DY, Hunt TK (1998) Time line of wound healing. Clin Podiatr Med Surg 15:1–9
Tandara AA, Mustoe TA (2004) Oxygen in wound healing— more than a nutrient. World J Surg 28:294–300
Bishop A (2008) Role of oxygen in wound healing. J Wound Care 17:399–402
Rodriguez PG, Felix FN, Woodley DT, Shim EK (2008) The role of oxygen in wound healing: a review of the literature. Dermatol Surg 34:1159–1169
Grey JE, Harding KG, Enoch S (2006) Venous and arterial leg ulcers. BMJ 332(7537):347–350. doi:10.1136/bmj.332.7537.347
Swift ME, Burns AL, Gray KL, DiPietro LA (2001) Age-related alterations in the inflammatory response to dermal injury. J Invest Dermatol 117:1027–1035
Minimas DA (2007) Ageing and its influence on wound healing. Wounds UK 3(1):42–50
Gilliver SC, Ashworth JJ, Ashcroft GS (2007) The hormonal regulation of cutaneous wound healing. Clin Dermatol 25:56–62
Godbout JP, Glaser R (2006) Stress-induced immune dysregulation: implications for wound healing, infectious disease and cancer. J Neuroimmune Pharmacol 1:421–427
Boyapati L, Wang HL (2007) The role of stress in periodontal disease and wound healing. Periodontology 2000(44):195–210
Goodson WH, Hunt TK (1979) Wound healing and the diabetic patient. Surg Gynecol Obstet 149:600–608
Kamal K, Powell RJ, Sumpio BE (1996) The pathobiology of diabetes mellitus: implications for surgeons. J Am Coll Surg 183:271–289
Brownlee M, Cerami A, Vlassara H (1988) Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. N Engl J Med 318:1315–1321
Yan SD, Schmidt AM, Anderson GM, Zhang J, Brett J, Zou YS et al (1994) Enhanced cellular oxidant stress by the interaction of advanced glycosylation end products with their receptors/binding proteins. J Biol Chem 269(13):9889–9897
Kivirikko KI, Laitinen O, Aer J, Halme J (1967) Metabolism of collagen in experimental hyperthyroidism and hypothyroidism in the rat. Endocrinology 80:1051–1061
Coutinho W (1999) Latin America consensus on obesity. Arq Bras Endocrinol Metabol 43:21–67
Pitanguy I, De Amorim NFG, Radwanski HN (2000) Contour surgery in the patient with great weight loss. Aesthet Plast Surg 24(6):406–411
Rosen JC, Orosan P, Reiter J (1995) Cognitive behavior therapy for negative body image in obese women. Behav Ther 26(1):25–42
Postlethwait RW, Johnson WD (1972) Complications following surgery for duodenal ulcer in obese patients. Arch Surg 105(3):438–440
Printen KJ, Paulk SC, Mason EE (1975) Acute postoperative wound complications after gastric surgery for morbid obesity. Am Surg 41(8):483–485
Matory WE, O’Sullivan J, Fudem G, Dunn R (1994) Abdominal surgery in patients with severe morbid obesity. Plast Reconstr Surg 94(7):976–987
Abdel-Moneim RI (1985) The hazards of surgery in the obese. Int Surg 70(2):101–103
Carlson MA (1997) Acute wound failure. Surg Clin N Am 77(3):607–636
Yale CE (1989) Gastric surgery for morbid obesity. Complications and long-term weight control. Arch Surg 124(8):941–946
Thompson WR, Ameral JF, Caldwell MD (1983) Complications and weight loss in 150 consecutive gastric exclusion patients. Critical review. Am J Surg 146(5):602–612
Grazer FM, Goldwyn RM (1977) Abdominoplasty assessed by survey, with emphasis on complications. Plast Reconstr Surg 59(4):513–517
Franz MG, Steed DL, Robson MC (2007) Optimizing healing of the acute wound by minimizing complications. Curr Probl Surg 44:691–763
Wagner AE, Huck G, Stiehl DP, Jelkmann W, Hellwig-Burgel T (2008) Dexamethasone impairs hypoxia-inducible factor-1 function. Biochem Biophys Res Commun 372:336–340
Hofman D, Moore K, Cooper R, Eagle M, Cooper S (2007) Use of topical corticosteroids on chronic leg ulcers. J Wound Care 16:227–230
Su WH, Cheng MH, Lee WL, Tsou TS, Chang WH, Chen CS et al (2010) Nonsteroidal anti inflammatory drugs for wounds: pain relief or excessive scar formation? Mediat Inflamm. doi:10.1155/2010
Waldron DR, Zimmerman-Pope N (2003) Superficial skin wounds. In: Slatter DH (ed) Textbook of small animal surgery. Saunders, New York, pp 260–271
Choudhry MA, Chaudry IH (2006) Alcohol intoxication and post burn complications. Front Biosci 11:998–1005
Radek KA, Matthies AM, Burns AL, Heinrich SA, Kovacs EJ, Dipietro LA (2005) Acute ethanol exposure impairs angiogenesis and the proliferative phase of wound healing. Am J Physiol Heart Circ Physiol 289:H1084–H1090
Radek KA, Kovacs EJ, DiPietro LA (2007) Matrix proteolytic activity during wound healing: modulation by acute ethanol exposure. Alcohol Clin Exp Res 31:1045–1052
Radek KA, Kovacs EJ, Gallo RL, DiPietro LA (2008) Acute ethanol exposure disrupts VEGF receptor cell signaling in endothelial cells. Am J Physiol Heart Circ Physiol 295:H174–H184
Fitzgerald DJ, Radek KA, Chaar M, Faunce DE, DiPietro LA, Kovacs EJ (2007) Effects of acute ethanol exposure on the early inflammatory response after excisional injury. Alcohol Clin Exp Res 31:317–323
Chan LK, Withey S, Butler PE (2006) Smoking and wound healing problems in reduction mammaplasty: is the introduction of urine nicotine testing justified? Ann Plast Surg 56:111–115
Ahn C, Mulligan P, Salcido RS (2008) Smoking—the bane of wound healing: biomedical interventions and social influences. Adv Skin Wound Care 21:227–238
Levin L, Schwartz AD (2005) The effect of cigarette smoking on dental implants and related surgery. Implant Dent 14:357–361
Balaji SM (2008) Tobacco smoking and surgical healing of oral tissues: a review. Indian J Dent Res 19:344–348
Siana JE, Rex S, Gottrup F (1989) The effect of cigarette smoking on wound healing. Scand J Plast Reconstr Surg Hand Surg 23:207–209
Goldminz D, Bennett RG (1991) Cigarette smoking and flap and full thickness graft necrosis. Arch Dermatol 127:1012–1015
Sorensen LT, Jorgensen S, Petersen LJ, Hemmingsen U, Bulow J, Loft S et al (2009) Acute effects of nicotine and smoking on blood flow, tissue oxygen, and aerobe metabolism of the skin and subcutis. J Surg Res 152:224–230
Shepherd AA (2003) Nutrition for optimum wound healing. Nurs Stand 18:55–58
Arnold M, Barbul A (2006) Nutrition and wound healing. Plast Reconstr Surg 117(7 Suppl):42S–58S
Gogia PP (1995) Physiology of wound healing. In: Gogia PP (ed) Clinical wound management. Thorofare, Slack, pp 8–12
Lanman TH, Ingalls TH (1937) Vitamin C deficiency and wound healing: an experimental and clinical study. Ann Surg 105(4):616–625
McDaniel JC, Belury M, Ahijevych K, Blakely W (2008) Omega-3 fatty acid’s effect on wound healing. Wound Repair Regen 16:337–345
Shingel KI, Faure MP, Azoulay L, Roberge C, Deckelbaum RJ (2008) Solid emulsion gel as a vehicle for delivery of polyunsaturated fatty acids: implications for tissue repair, dermal angiogenesis and wound healing. J Tissue Eng Regen Med 2:383–393
Burgess C (2008) Topical vitamins. J Drugs Dermatol 7(7 Suppl):s2–s6
Campos AC, Groth AK, Branco AB (2008) Assessment and nutritional aspects of wound healing. Curr Opin Clin Nutr Metab Care 11:281–288
Grey JE, Enoch S, Harding KG (2006) Wound assessment. BMJ 332(7536):285–288. doi:10.1136/bmj.332.7536.285
Kumar KS, Reddy BE (2014) Wound image analysis classifier for efficient tracking of wound healing status. Signal Image Process Int J 5(2):15–27
World Union of Wound Healing Societies (2007) Principles of best practice: wound exudate and the role of dressings. A consensus document. MEP Ltd, London
Robins (2003) Basic pathology, 7th edn. Elsevier, Amsterdam. ISBN: 818147-148-2
Krasner D (1995) Wound care. How to use red–yellow–black system. AJN 95(5):44–47
Manakar NB, Nagdeve UT (2013) Comparison of different imaging techniques used for chronic wounds. IJRET 2(7):68–70
Zhou AH (2012) A survey of optical imaging techniques for assessing wound healing. Int J Intell Control Syst 17(3):79–85
Falanga V (2000) Classifications for wound bed preparation and stimulation of chronic wounds. Wound Repair Regen 8:347–352
Schultz GS, Sibbald RG, Falanga V, Ayello EA, Dowsett C, Harding K, Romanelli M, Stacey MC, Teot L and Vanscheidt W (2003) Wound bed preparation : a systematic approach to wound management. Wound Repair Regen 11(2):S1–S27
Flanagan M (2013) Principles of wound management. In: Flanagan M (ed) Wound healing and skin integrity: principles and practice. Wiley-Blackwell, London, pp 66–83. ISBN: 978-0-470-65977-9
Wounds UK (2013) Effective debridement in a changing NHS: a UK consensus. Wounds UK, London. www.wounds-uk.com
Strohal R, Dissemond J, O’Brien J, Piaggesi A, Rimdeika R, Young T et al (2013) An updated overview and clarification of the principle role of debridement. EWMA document: debridement. J Wound Care 22:S1–S52
Dodds S, Haynes S (2004) The wound edge, epithelialization and monitoring wound healing. A journey through TIME. Wound bed preparation in practice. Br J Nurs Supplement 13(18):23–26
Borle RM (2014) Textbook of oral and maxillofacial surgery. Chapter 2: Sutures, 1st edn. Jaypee Brothers, New Delhi. ISBN: 978-93-5152-009-2
Turner TD (2001) Development of wound management products in chronic wound care. In: Krasner D, Rodeheaver G, Sibbald RG, (eds) Chronic wound care: a clinical source book for healthcare professionals, 3rd edn. HMP Communications, Wayne, PA
https://nstupharma.files.wordpress.com/2012/11/maimum-surgical-dressing1.pdf
Hyslop PA, Hinshaw DE, Scraufsratter IU (1995) Hydrogen peroxide as a potent bacteriostatic antibiotic: implications for host defense. Free Radic Biol Med 19(11):31–37
Shenoy VP, Balla M, Shivananda PG, Bairy I (2012) Honey as an antimicrobial agent against Pseudomonas aeruginosa isolated from infected wounds. J Glob Infect Dis 4(2):102–105. doi:10.4103/0974-777X.96770
Bergman A, Yanai J, Weiss J, Bell D, David MP (1983) Acceleration of wound healing by topical application of honey: an animal model. Am J Surg 145(3):374–376
Atherton P (1998) Aloe vera: magic or medicine? Nurs Stand 12(49):52–54
Davis RH, Didonato JJ, Hartman GM, Haas RC (1994) Anti-inflammatory and wound healing activity of a growth substance in aloe vera. J Am Podiatr Med Assoc 84(2):77–81
Yadav KC, Kumar RJ, Basha S, Deshmukh GR, Gujjula R, Santhamma B (2012) Wound healing activity of topical application of aloe vera gel in experimental animal models. Int J Pharm Bio Sci 3(2):63–72
Higley HR, Ksander GA, Gerhardt CO, Falanga V (1995) Extravasation of macromolecules and possible trapping of transforming growth factors-beta in venous ulcerations. Br J Dermatol 132:79–85
Trengone NJ, Stacey MC, MacAuley S (1999) Analysis of acute and chronic wound environment: the role of proteases and their inhibitors. Wound Repair Regen 7:442–452
Trengone NJ, Ohmann HB, Stacey MC (2000) Miogenic activity and cytokine levels in nonhealing and healing chronic leg ulcers. Wound Repair Regen 8:13–25
Robson MC, Smith PD (2001) Topical use of growth factors to enhance healing. In: Falanga V (ed) Cutaneous wound healing. Martin Dunitz, London, pp 379–398
Margolis DJ, Bartus C, Hoffstad O, Malay S, Berlin JA (2005) Effectiveness of recombinant human PDGF for treatment of diabetic neuropathic foot ulcers. Wound Repair Regen 13:531–536
Hess CT (2005) Wound care, 5th edn. Lippincott Williams and Wilkins, Baltimore
Zhang X, Wu X, Wolf SE, Hawkins HK, Chinkes DL, Wolfe RR et al (2007) Local insulin zinc injection accelerated skin closure donor site wound healing. J Surg Res 142:90–96
Greenway SE, Filler LE, Greenway FL (1999) Topical insulin in wound healing: a randomized double blind, placebo controlled trial. J Wound Care 8:526–528
Rezvani O, Shabbak E, Aslam A, Bidar R, Jafari M, Safanezhad S (2009) A randomized double blind placebo controlled trial to determine the effects of topical insulin on wound healing. Ostomy Wound Manag 55:22–28
Chen X, Liu Y, Zhang X (2010) Topical insulin application improves healing by regulating the wound inflammatory response. Wound Repair Regen 20:425–434
Baumann LS, Spencer J (1999) The effects of topical vitamin E on the cosmetic appearance of scars. Dermatol Surg 25:311–315
Pinnel SR (1999) Regarding d-alpha tocopherol. Dermatol Surg 25:827
Mackay D, Miller AL (2003) Nutritional support for wound healing. Altern Med Rev 8:359–377
Hopkins JT, McLoda TA, Seegmiller JG, David Baxter G (2004) Low-level laser therapy facilitates superficial wound healing in humans: a triple-blind, sham-controlled study. J Athl Train 39(3):223–229
Silva EC, Filho AH, Musskopf DE (1998) Radiação laser. In: Rodrigues EM (ed) Manual de recursos terapêuticos. Revinter, Rio de Janeiro, pp 17–35
Karu T, Pyatibrat L, Kalendo G (1995) Irradiation with He–Ne laser increases ATP level in cells cultivated in vitro. J Photochem Photobiol, B 27:219–223
Bibikova A, Belkin V, Oron U (1994) Enhancement of angiogenesis in regenerating gastrocnemius muscle of the toad (Bufo viridis) by low-energy laser irradiation. Anat Embryol (Berl) 190:597–602
Kloth LC, Mc Culloch MJ (1996) Promotion of wound healing with electrical stimulation. Adv Wound Care 9(5):42–45
Weller C, Sussman G (2006) Wound dressings update. J Pharm Pract Res 36(4):318–324
Tocco I, Zavan B, Bassetto F, Vindigni V (2012) Nanotechnology-based therapies for skin wound regeneration. J Nanomater. doi:10.1155/2012/714134
Whitehead W (1891) A hundred cases of entire excision of the tongue. Br Med J 1(1583):961
Davies H, Carr R (1990) Osteomyelitis of the mandible: a complication of routine dental extractions in alcoholics. Br J Oral Maxillofac Surg 28(3):185–188
Stanley D, Emerson D, Daley J (1988) Whitehead’s varnish and Jelonet—a better dressing for skin graft donor sites than Jelonet alone. Ann R Coll Surg Engl 70(6):369
Stoelinga P, Bronkhorst F (1988) The incidence, multiple presentation and recurrence of aggressive cysts of the jaws. J Cranio-Maxillofac Surg 16:184–195
Eyre J, Zakrzewska J (1985) The conservative management of large odontogenic keratocysts. Br J Oral Maxillofac Surg 23(3):195–203
Hellem S, Nordenram A (1973) Prevention of postoperative symptoms by general antibiotic treatment and local bandage in removal of mandibular third molars. Int J Oral Surg 2(6):273–278
Rowe-Jones J, Adam E, Moore-Gillon V (1993) Subtle diagnostic markers of orbital floor blow-out fracture on coronal CT scan. J Laryngol Otol 107(02):161–162
Braithwaite F, Maurice D (1968) The importance of the levator palati muscle in cleft palate closure. Br J Plast Surg 21(1):60–62
Morison R (1917) Remarks on the treatment of infected, especially war wounds. Br Med J 2(2964):503–506
Nakhla V, Takwoingi YM, Sinha A (2007) Myringoplasty: a comparison of bismuth iodoform paraffin paste gauze pack and tri-adcortyl ointment ear dressing. J Laryngol Otol 121(4):329–332
Kotecha B, Fowler S, Harkness P, Walmsley J, Brown P, Topham J (1996) Management of epistaxis: a national survey. Ann R Coll Surg Engl 78(5):444–446
Corbridge RJ, Djazaeri B, Hellier WP, Hadley J (1995) A prospective randomised controlled trial comparing the use of merocel nasal tampons and BIPP in the control of acute epistaxis. Clin Otolaryngol Allied Sci 20(4):305–307
Flook EP, Uddin FJ, Johnston MN (2006) The need to include BIPP reactions in routine consent. Clin Otolaryngol 31(2):165–166
Youngman L, Harris S (2004) BIPP madness: an iatrogenic cause of acute confusion. Age Ageing 33(4):406–407
Elvis AM, Ekta JS (2011) Ozone therapy; a clinical review. J Nat Sci Biol Med 2(1):66–70. doi:10.4103/0976-9668.82319
O’Neil T (1975) Antibacterial properties of periodontal dressings. J Periodontol 46(8):469
Singh V, Das S, Sharma NK (2012) Iodoform—a boon in disguise. Open Journal of Stomatology. doi:10.4236/ojst.2012.24055
Hahler B (2006) Surgical wound dehiscence. Medsurg Nurs 15:296–300
Amini AQ, Khan NA, Ahmed J, Memon AS (2013) Management of abdominal wound dehiscence: still a challenge. Pak J Surg 29(2):84–87
Russell SB, Trupin JS, Kennedy RZ, Russel JD, Davidson JM (1995) Glucocorticoid regulation of elastin synthesis in human fibroblasts: down regulation in fibroblasts from normal dermis but not from keloids. J Invest Dermatol 105:241–245
Babu M, Diegelmann R, Oliver N (1989) Fibronectin is overproduced by keloid fibroblasts during abnormal wound healing. Mol Cell Biol 9:1642–1650
Brissett AE, Sherris DA (2001) Scar contractures, hypertrophic scars, and keloids. Facial Plast Surg 17:263–272
Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschkw MG (2011) Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med 17(1–2):113–125. doi:10.2119/molmed.2009.00153
Mutalik S (2005) Treatment of keloids and hypertrophic scars. Indian J Dermatol Venereol Leprol 71(1):3–8
Naeini FF, Najafian J, Ahmadpour K (2006) Bleomycin tattooing as a promising therapeutic modality in large keloids and hypertrophic scars. Dermatol Surg 32:1023–1029 (discussion 1029-1030)
Segev F, Jaeger-Roshu S, Gefen-Carmi N, Assia EI (2003) Combined mitomycin C application and free flap conjunctival autograft in pterygium surgery. Cornea 22:598–603
Wolfram D, Tzankov A, Pulzi P, Katzer HP (2009) Hypertrophic scars and keloids. A review of their pathophysiology, risk factors, and therapeutic management. Dermatol Surg 35:171–181. doi:10.1111/j.1524-4725.2008.34406.x
Healy B, Freedman A (2006) Infections. BMJ 332(7545):838–841
Tregdet EE, Nedelec B, Scott PG, Ghahary A (1997) Hypertrophic scars and contractures: the cellular and molecular basis for therapy. Surg Clin N Am 77(3):701–730
Moioli EK, Bakus AD, Yaghmai D, Hernandez C (2011) Treatment strategies for pigmentation disorders in skin of color. Cosmet Dermatol 24(11):524–531
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Shruti Chhabra, Naveen Chhabra, Avneet Kaur and Niti Gupta declare that they have no conflict of interest.
Ethics Statement/Confirmation of Patient Permission
This article does not contain any studies with human/animal participants performed by any of the authors.
Rights and permissions
About this article
Cite this article
Chhabra, S., Chhabra, N., Kaur, A. et al. Wound Healing Concepts in Clinical Practice of OMFS. J. Maxillofac. Oral Surg. 16, 403–423 (2017). https://doi.org/10.1007/s12663-016-0880-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12663-016-0880-z