RCS 6080 Medical and Psychosocial Aspects of Rehabilitation Counseling Wound Healing & Plastic Surgery
Wounds Any breach in the surface of the body or any tissue disruption produced by the application of energy Usually physical injury Abrasion, degloving injury Contusion, crush injury Incision, laceration
Skin content refresher
Wound Healing As wound heals: –Fluid and cells drain from damaged tissue –Exudate may be: Clear Bloody Pus-containing Proper wound healing: –Cleanliness and care of lesion –Proper circulation –Good general health and nutrition
Phases of healing Inflammatory –Bleeding/clotting –Migration of WBCs –Cell swelling Reparative –Laying down of collagen + migration of epith. cells –New capillary loops –Proliferation of fibroblastsstrands of collagen Consolodative –reorientation +contraction of collagen –collagen synthesisdegradation – vascularity
Complications Hypertrophic scar = continued production of collagen Keloid = ….with extension into surrounding tissues Scar contracture
Plastic surgery Scar Revision –Laser resurfacing/dermabrasion –Z-plasty –Skin-grafting/flap surgery –Tissue expansion