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Jenkin's rule was the first research result in this area, showing that the then-typical use of a suture-length to wound-length ratio of 2:1 increased the risk of a burst wound, and suggesting a SL:WL ratio of 4:1 or more in abdominal wounds. [19] [20] A later study suggested 6:1 as the optimal ratio in abdominal closure. [21]
A surgical incision is a cut made through the skin and soft tissue to facilitate an operation or procedure.Often, multiple incisions are possible for an operation. In general, a surgical incision is made as small and unobtrusive as possible to facilitate safe and timely operating conditions and recovery.
A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. [1] [2] Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying disease processes such as diabetes mellitus, venous/arterial insufficiency, or immunologic disease. [3]
The wound can be allowed to close by secondary intention. Alternatively, if the infection is cleared and healthy granulation tissue is evident at the base of the wound, the edges of the incision may be reapproximated, such as by using butterfly stitches , staples or sutures .
The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure. The wound is purposely left open. Examples: healing of wounds by use of tissue grafts. If the wound edges are not reapproximated immediately, delayed primary wound healing transpires. This type of healing may be desired in the case of contaminated wounds.
Postoperative wounds are those wounds acquired during surgical procedures. Postoperative wound healing occurs after surgery and normally follows distinct bodily reactions: the inflammatory response , the proliferation of cells and tissues that initiate healing , and the final remodeling .
Because Vicryl is slow-absorbing and often braided, its use is contraindicated in the closure of any cutaneous wound exposed to the air, as it draws moisture from the healing tissue to the skin and allows bacteria and irritants to migrate into the wound.
The International Red Cross wound classification system is a system whereby certain features of a wound are scored: the size of the skin wound(s); whether there is a cavity, fracture or vital structure injured; the presence or absence of metallic foreign bodies. A numerical value is given to each feature (E, X, C, F, V, and M).