Category & Concepts
The interpretation of traumatic wounds and ulcers with Human Body Regenerative Restoration Science and Theory
In according with Human Body Regenerative Restoration Science and theory, the traumatic wounds mean the earlier wound (fresh), such as scratch, bruise, laceration, crush injuries, open fracture and etc; ulcers refer to the deficits of dermal mucosa or deep soft tissue in combination with chronic infection and the lesion can not be timely healed. The ulcer is the non-healing wound. The wound stops growing or do not grow, long-term exudates, ageing granulation tissue and non-vitality.
2.1. Definition of ulcers
      Any refractory ulcerative lesions on the skin, soft tissue, tendon and bone belong to traumatic wounds and ulcers. The major characteristics include: Having the dermal and mucosal signs and symptomsPathological changes include wound exudatesinfectionulceration and etcHaving damages of dermal mucosa and soft tissue.
2.2. Definition of traumatic wounds
2.2.1. Traumatic wounds refer to open wounds on the skin, mucosa, soft tissue, muscle tissue and bone and the open penetrating wounds caused by firearm.
2.2.2. The classifications of traumatic wounds based on injury type: non necrotic tissue type, necrotic tissues type, specific type.
2.2.3. The non necrotic tissue type mainly refers to: dull wounds, donation site, tissue sharp severing wounds, extremity sharp severing injuries, surgical sites, tissue severing section after surgical procedure and etc.
2.2.4. The necrotic tissue type mainly refers to: blunt injuries, scratches, tearing, laceration, exfoliation injuries, explosion injuries, crush injuries, open fracture, open bone exposure, extremities blunt severing injuries, exfoliative dermatitis, mucosal trauma and etc.
2.2.5. The specific type: burns, scalds, electronic injuries, chemical burns, cold injury and open penetrating injuries by firearm.
2.3. The pathological changes of traumatic wounds
The pathological changes in common: exudationinflammationrepairing;
2.3.1. Exudation: Due to the rupture of tissues, the vessels are broke down. First, bleeding, then induce the stress response, the injured local tissue appears self-protection; at the same time, large amounts of inflammatory factors produce on the local wounds that leads to the occurrence of inflammatory reaction and then causes exudation.
2.3.2. Inflammation: inflammation is a normal and requisite self-acting process for normal healing of all types of wounds. Regardless of the sizes of the wound or the causes (blunt or penetrating), all traumas will occur the inflammatory reaction that is either one kind of self-protection or the pathological changes of tissue injury.
2.3.3. Repairing: The inflammatory reaction is the prelude of repairing. If the inflammatory reaction safely finishes the pathological reaction, the tissue self-restoration will be activated. At the time, both the tissue cells and fibrin that ooze from vessels will involve in the process of wound sealing to realize the healing of the wound at last. If the wound occurred infection (or can not be healed by self-repairing process), it will make the wound deteriorated and the repairing and healing can not be achieved.
2.4. The clinical characteristics of traumatic wounds (onset periods and laws)
2.4.1. Penetrating trauma: mainly concerns on common pathological changes. If there were no infection, if the wound edges could be properly closed, if there were histological foundation of self-healing, all of the wound can heal by itself.
2.4.2. Blunt trauma: Clinical onset and characteristic has the relationship with the depth and types of tissue injury. Such as the scratch that affects the superficial layer of the skin, its heal process basically concerns on the common pathological changes; if the injury affects subcutaneous tissue, soft tissue, muscle and bone, its clinical pathological changes are not only complicated, but also the tough problem in current clinical treatment.
2.5. The onset process of blunt trauma (can be divided into six stages)
The first stage: stress response (within one week after injury);
The second stage: acute inflammation and acute infection (within the second week after injury);
The third stage: wound restoration and common infection (within the third week after injury);
The fourth stage: the separation of necrotic tissue and infection (within the fourth week after injury);
The fifth stage: rejection from necrotic tissue and infection (after the fourth week post-injury)
The sixth stage: restoration of deep remnant tissue and ulceration (after the fourth week post-injury).
2.6. Current interventions to traumatic wounds
2.6.1. Interventions to penetrating fresh wounds: Suture or skin-grafting to seal the wounds.
2.6.2. Interventions to penetrating non-fresh & non-cleaning wounds: disinfect and perform the debridement, but it is difficult to make granulation tissues grow and prevent infection.
2.6.3. Interventions to blunt fresh clean wounds: suture or perform debridement and skin-grafting to seal the wound, but it is difficult to prevent infection and the infection caused by the rejection from necrotic tissue and make granulation tissues grow.
2.6.4. Interventions to blunt non-fresh and non-clean wounds: perform thorough debridement, wait the growth of granulation tissue; perform skin-grafting or flap to seal the wound as necessary; but it is difficult to make the granulation tissue grow and prevent the infection with low curative rate of skin-grafting or flap. And it is hardly to prevent the infection caused by the rejection from necrotic tissue.
2.6.5. Interventions to severed fingers or bone deficits: no ways to repair or restore.
2.7. The capability of Chinese Burn Association of the Integrity of Traditional and Western Medicine to treat wounds
In all hospitals at medical network of Chinese Burn Association of the Integrity of Tradition and Western Medicine, the standard application of regeneration of granulation tissues techniques, maintenance of physiologically moisture environment techniques, in advance liquefaction and discharging of necrotic tissues, ensure the wounds clean that will facilitate the growth of granulation tissues, skin-grafting, skin-flap grafting, or in situ regeneratively restoration on the wounds to solve the problem of retractable traumatic wounds.