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Acute Wounds

Acute wounds are skin injuries which normally heal within 4 weeks, however, depending on size, depth, and extent of damage in the epidermis and dermis, healing may take longer. In general, acute wounds are divided into wounds with an accidental cause (traumatic wounds) or wounds caused by a planned intervention, such as surgical wounds. Traumatic wounds can range from minor injuries to severe ones and include abrasions, lacerations, skin tears, bites, and burns injuries. Healing of acute wounds typically follows the body’s own natural orderly and timely orchestrated programme.

 

Burns Injuries

Burn injuries can be categorised in 1st , 2nd, 3rd, and 4th degree burns depending on the depth and size;
  •  1st degree burns only involve the epidermis and are characterised by redness and pain.
  • 2nd degree (partial thickness) burns affect the epidermis as well as some parts of the dermal layer and can be further subcategorised into superficial partial thickness (grade IIa) and deep partial thickness wounds (grade IIb). Moisture develops due to loss of barrier function in the epidermis. Damaged, dermal nerves and blood vessels result in pain and redness.
  •  3rd degree burns consist of extended injuries to the whole dermis layer with some of the tissues below the skin affected.
  •  4th degree burns include the subcutaneous tissue and can also severely damage muscles, tendons, bone, and joints.

According to the WHO, about 11 million burn victims are injured severely enough to require medical attention every year and about 265,000 deaths every year are caused by burns. Children account for almost half of the cases with severe burn injuries. Adult burn cases typically result from thermal (scalds, flame, contact), electrical, or chemical sources. Other important causes include radiation and extreme cold (frostbite).

Initial treatment of burns typically includes cooling with water. This prevents progression of the burn injury and limits tissue damage. A fresh burn is essentially sterile and should be kept clean and moist to promote the development of healthy granulation tissue

Currently, a wide variety of dressings are available for the treatment of partial thickness burn wounds, but none has strong evidence to support their use. Modern alternatives include skin grafts, bioengineered skin substitutes, and biosynthetic dressings which produce physiological wound closure until the epidermal layer has been repaired.

WMCS is an exceptionally effective therapy for burns patients. The burned area will produce a thin layer of new skin after the first WMCS treatment, prior to the application of a primary dressing. Thus the area will be less painful in the event of contact. Subsequent WMCS treatments can be done without removing the primary dressing, thus no need for painful dressing changes.

 

Other benefits with WMCS for burn injuries include:
  •  Healing time is dramatically reduced, thus patients will be able to leave hospital faster, leading to significant cost savings.
  •  The patient will be pain free much faster, thus pain medication can cease after only 1-2 days. High patient comfort.
  •  In many cases, avoidance or minimization of the need for skin grafts.

 

Longer-term effects include less scaring and improved pigmentation of the healed skin.

WMCS Case Study from Virachaivej International Hospital Bangkok Thailand

Surgical wounds

Surgical wounds are the result of a planned procedure, either elective or emergency, where the clinician creates a wound in order to perform a surgical intervention. A surgical wound may be either incised and closed (healing by primary intention) or incised and laid open (healing by secondary intention). This wound type is expected to follow a rapid, predictable pathway towards healing.
An important surgical procedure is skin grafting aiming to restore function to the affected skin area and improve overall appearance. A skin graft will result in wounded tissue both at the donor site as well as where the skin graft is applied.

The ageing population, linked with an increased demand for aesthetic treatments (now also among the male population), and the availability of new aesthetic techniques are all factors fuelling the global growth of aesthetics surgery. In Asia-Pacific this growth is particularly fast, driven by the region’s appeal as a destination for medical tourism, the rising middle class with increasing disposable income, and growing awareness about aesthetic specialties.

A major complication of all types of surgical wounds is the infection risk. These infections can occur up to 30 days following surgery, and in the event of implants, up to 1 year. Despite innovations in surgical techniques and technological advances, surgical site infections remain a major source of morbidity and mortality in patients following surgery. Prophylactic measures often include the use of antibiotics and de-contamination washes.

A suitable adjunct therapy for wound healing of surgical wounds is electrical stimulation. It has shown to decrease bacterial infection, to increase local perfusion, and to accelerate wound healing, thereby addressing three pivotal factors of surgical complications.

Post-operative WMCS therapy as a routine procedure following any surgical intervention will help accelerate the natural healing process. WMCS will reduce swelling and provide faster healing with less risk of infection. In addition, the more controlled healing provided by WMCS will reduce the risk of longer term scaring and pigmentation changes, which are critical outcomes — not only for aesthetic surgery patients.

 

In the case of skin grafting, WMCS therapy will accelerate healing time, reduce the risk of rejection, reduce the risk for infections and improve the longer-term outcome of the skin graft. In addition, WMCS is really beneficial for the treatment of the “donor site”, from which skin has been harvested, not least to improve scaring and pigmentation outcome.

 

WMCS has also been successfully used in the treatment of other forms of Traumatic Wounds, such as abrasions, lacerations and skin tears.

WMCS Case study from Riverton Medical Centre, Perth, Australia