RT Book, Section A1 Heffernan, Daithi S. A1 Adams, Charles A. A1 Cioffi, William G. A2 Moore, Ernest E. A2 Feliciano, David V. A2 Mattox, Kenneth L. SR Print(0) ID 1141191146 T1 Wounds, Bites, and Stings T2 Trauma, 8e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071847292 LK accesssurgery.mhmedical.com/content.aspx?aid=1141191146 RD 2024/03/28 AB Wounds, whether created electively or as a result of traumatic injury, are an integral component of the surgical patient thus understanding the pathways and mechanisms of wound healing is critical for the optimal care of surgical patients. This fund of knowledge is applicable to the care of patients with acute wounds as well as facilitates the development of therapeutic options for patients with chronic or nonhealing wounds. Wound healing is often divided into phases in order to aid understanding of this complex process and these are the early inflammatory phase, the intermediate proliferative phase, and the late maturational and remodeling phase. Although these phases are often described as discrete events, it is important to realize that characteristics and elements of these phases overlap. Wound repair is a dynamic and complex process of inflammation characterized by a well-coordinated pattern of cell migration, proliferation and differentiation, along with angiogenesis and matrix remodeling. The essential characteristics of the early phase include hemostasis and inflammation. The intermediate phase is characterized by cell proliferation, migration, angiogenesis, and epithelialization while the late phase involves collagen production with contraction of the wound. Ultimately, even in normal wounds, the wound undergoes continuous remodeling for the rest of the patient’s life (Table 47-1).