Definition & Overview
Wounds are repaired using different methods based on their size and severity. While mild and small wounds only require simple wound closure treatment, larger and more complex wounds are managed using complex treatment techniques.
In general, the wound healing process of an average adult is sub-divided into 4 different phases, namely hemostasis, inflammatory, proliferation, and maturation. The purpose of proper wound repair is to speed up this process while minimising the risks involved. The procedure secondary purpose is to keep the wound from becoming infected.
Who Should Undergo and Expected Results
Simple, intermediate, and complex wound repair is carried out for those who suffer from various types and degrees of wounds, including:
- Non-penetrating wounds
- Scrapes or abrasions
- Cuts or lacerations
- Penetrating wounds
- Stab wounds
- Surgical wounds
- Gunshot wounds
- Miscellaneous wounds
- Thermal wounds
- Chemical wounds
- Electrical wounds
These wounds present with various degrees of pain, swelling, redness, bleeding, and compromised function of the affected area as well as pus drainage, fever, and infection. Different types of wounds thus require different types of wound repair, which are coded as simple, intermediate, and complex. The proper type of wound repair to use depends on the signs and symptoms of the wound, its depth, and its cause.
A successful wound repair procedure ensures that:
- The wound completes the proper healing process, from hemostasis, inflammatory, proliferation, and maturation
- Scarring is minimised
- Infection is prevented
How is the Procedure Performed?
Wound repairs are classified as simple, intermediate, or complex.
Simple – A simple wound repair is used for superficial wounds, such as shallow cuts or lacerations that affect only the epidermis, dermis, and the subcutaneous tissues. Such wounds can be repaired using a simple one-layer suture or closure, which is often performed under local anaesthesia. If the wound is open, electrocauterisation can also be used for closure.
Intermediate – An intermediate wound repair is used for heavily contaminated wounds or those that require a layered closure as one or more of the deeper layers are affected. If the wound is contaminated, it is first cleaned to make sure all particulate matters are removed; this immediately qualifies as an intermediate removal.
Complex – A complex wound repair refers to more complicated techniques such as scar revision, debridement, stenting, and retention sutures. Wounds wherein nerves, blood vessels, and tendons have to be repaired are also considered as complex.
All wound repair procedures end with dressing and proper wound care, which may involve the application of either topical or oral local antibiotics.
Possible Risks and Complications
Proper wound repair and healing can be affected by many factors. These factors may delay or inhibit proper healing, which makes the repair procedure unsuccessful. These factors include:
- Disease, such as diabetes
Guo S, DiPietro LA. “Factors affecting wound healing.” J Dent Res. 2010 Mar; 89(3): 219-229. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903966/
Armstrong DG. “Wound healing and risk factors for non-healing.” http://www.uptodate.com/contents/wound-healing-and-risk-factors-for-non-healing
Thomsen TW, Barclay DA, Setnik GS. “Basic laceration repair.” N Engl J Med 2006; 355:e18. http://www.nejm.org/doi/full/10.1056/NEJMvcm064238