Wound care is important for any reconstructive surgery that seeks to correct damage caused to nerves muscles, the skeleton, or skin. Plastic and reconstructive surgeons select methods to address wound care based on the size, severity, and features of the wound. Examples of approaches to wounds include skin grafts, tissue expansion, and flap and microsurgery. Direct closure, the most simple of wound care procedures, may be performed on skin-surface wounds that have straight edges, such as a simple cut. Wound care can sometimes mean using devices to get a wound ready for a surgical procedure. A wound vac on a wound will help make it smaller so that it will be easier to graft or flap later.
Who Can Benefit From Wound Care?
Wound care is intended to assist individuals suffering from severe burns, or severe scarring from burns and other injuries, and wounds that cannot heal normally. The goal is to improve appearance and function of skin deformed by burns and other trauma, and to help prevent infection, morbidity and diseases to the wound.
How Wound Care Procedures Work
Skin grafts assist in closing a wound that lacks sufficient soft tissue to adequately cover the traumatized area and insure healing. This procedure may be conducted with local or general anesthesia depending on the extent of the wound, and it is completed in combination with a reconstructive procedure.
If Dr. Sattler is treating you for a burn wound, he may use a split-thickness skin graft that is composed of the layers of skin closest to the surface. Full-thickness skin grafts are often selected to treat burn wounds that are both deep and large, or to cover joints where maximum skin elasticity and movement are necessary. Composite grafts consist of layers of skin, fat, and sometimes even cartilage from the donor site in order to provide the wound more support.
Grafts are also distinguished according to the type of material used. They can be autografts, in which the tissue is taken from another part of the patient's body. Allografts are made from tissues of another human being, and even xenografts from other species.
During tissue expansion, a silicone balloon expander is inserted under the skin under treatment. The expander comprises a tiny tube and self-sealing valve that allows the surgeon to gradually fill the expander with saline solution; the valve is usually left just beneath skin surface. When enough extra skin has grown, the expander is removed and the new skin is used to close the wound. Local or general anesthesia may be used.
Flap and microsurgery are often used in severe injuries that require maximal precision, for example, in reconnecting blood vessels. During microsurgery, Dr. Sattler will use a microscope in order to aid in the intricate task of repairing nerves, reconstructing damaged skin, muscles, and other tissues depending on the wound.
Flap surgery involves the transplantation of living tissue from one part of the body to another. Some flaps carry their own blood supply, while others must be attached to a blood supply at the recipient site, usually with microsurgery. Flap surgery can help restore form and function to traumatized areas of the body exhibiting damaged skin, fat, muscle movement, and/or skeletal support. Again, depending on the extent of the wound and complexity of the procedure, either local or general anesthesia may be used.
After Wound Care Procedures
Regardless of your wound and the procedure used, you can expect some discomfort and swelling, symptoms that can be managed with pain medication. Dressings will be applied which should remain dry and intact in order to ensure proper healing. Either absorbable, non-absorbable sutures or staples may be used. Your surgeon will be sure to review detailed instructions on how you are to care for the suture lines; some sutures require regular treatment with antimicrobial ointment, while others require little maintenance. Non-absorbable sutures will be removed within one to three weeks after surgery.
Dr. Sattler welcomes your questions and concerns regarding wound care in LA County. Please contact his office at the plastic surgery center in Glendora nearby Arcadia and Azusa if you would like to set up a consultation.