SOFT-TISSUE WOUND MANAGEMENT

www.PRSJournal.com 9S Department of Plastic Surgery Wound Healing Burns, Hôpital La Colombière, Montpellier University Hospital; and the Department of Plastic, Reconstructive and Aesthetic Surgery, Kyorin University School of Medicine. Received for publication May 4, 2020; accepted October 12, 2020. Copyright © 2020 by the American Society of Plastic Surgeons DOI: 10.1097/PRS.0000000000007628 Wound care has been a field of interest for surgeons since the antique times. Pioneers made it a new medical field, with surgical components and induced a large interest in different medical specialties such as plastic surgery, dermatology, diabetology, rehabilitation, and geriatrics. A growing knowledge has been accumulated, and a better understanding of the risk factors, the comorbidities, and, more globally, the need for a multidisciplinary approach of complex wounds emerged at this time. New medical devices and drugs were regularly proposed (i.e., dressings and topical agents) that were more and more complex and specifically designed for managing the symptoms of a wound, such as debridement, exudation, promotion of granulation tissue, epidermization, and scar prevention. Some of them drastically modified the outcome of large wounds exposed to infection, such as negative-pressure wound therapy (NPWT), a technique that was proposed in 1997 by Morykwas,1 with successive evolution to the presently used NPWT instillation, itself capable of improving promotion of the granulation tissue when used with a newly designed perforated foam.2 However, the perfect randomized controlled trial with significant differences has not yet been obtained. HISTORICAL DATA When going back to prehistoric times, some reports mention that women and daughters of soldiers sucked the wounds of their relatives who are coming back from battles, and Avicenne wrote chapters on the interest of honey on wound healing.3 These premises of medical devices were used all along the medical evolution, and specifically in wound infection by Galien,4 who voluntarily provoked infection in wounds (laudable pus). In the middle age magics, superstition and science were intricated and alchemists invented formulas capable of healing wounds. Later Pfannenstiel demonstrated the interest of hygiene and washing hands in prevention of transmission of the puerperal fever during delivery.5 The development and diffusion of penicillin during the second world war was initially used in Boston when the Cocoanut Grove fire, a night club in Boston, caused 496 deaths and more than 500 severe burns.6 In the 20th century, modern wound healing was developed. In 1962, Winter7 demonstrated that chronic wounds were better managed when covered using absorptive dressings, changing the paradigm and opening the development of modern dressings. At the present time, more than 5000 wound care products are available on the market. Most modern dressings contain Luc Teot, MD, PhD Norihiko Ohura, MD