Maui – Promising strategies to promote wound healing range from relatively straightforward drugs and debridement techniques to meticulous manipulation of skin grafts and donor sites, using techniques such as laser-assisted application of mesenchymal stem cells (MSCs), said an expert at MauiDerm 2015.
These new tools and techniques have arisen from dermatologists' ever-evolving concept of wound healing, said Robert S. Kirsner, M.D., Ph.D. He is chairman (interim) and Harvey Blank Professor, Department of Dermatology & Cutaneous Surgery; Professor of Epidemiology and Public Health; and Director of the Wound Center at the University of Miami Miller School of Medicine.
In educating residents, his department emphasizes that many of the conditions they see actually involve wounds – though they may not realize it. Along with chronic skin ulcers, burns and traumatic injuries, Dr. Kirsner explained, everything from cancers and inflammatory conditions to genetic autoimmune diseases and drug reactions presents with wounding.
Versus general surgeons and plastic surgeons, he added, "We create three to six times as many wounds that we must repair. So we should know how to take care of those wounds."
To that end, Dr. Kirsner suggested viewing wounds along a continuum of healing outcomes. Between normal healing and chronic wounds lies a wide spectrum of abnormal healing. The Holy Grail, he added, is scarless healing, as occurs in fetuses during the first two trimesters of gestation.