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Plastic Surgery106 papers

Postoperative wound infection-superficial

Last edited: 3 h ago

Overview

Superficial postoperative wound infections occur at the donor site following split-thickness skin grafting (STSG) and other surgical procedures, posing a significant clinical challenge due to delayed healing and potential complications such as cellulitis, abscess formation, and impaired graft take. These infections primarily affect patients undergoing reconstructive surgeries, burn treatments, and various dermatological procedures. Early recognition and management are crucial to prevent progression to deeper infections and to ensure optimal wound healing. Understanding and addressing superficial wound infections is essential for maintaining patient safety and improving surgical outcomes in day-to-day practice 1 5 7.

Pathophysiology

Superficial wound infections at donor sites typically arise from contamination during surgery or from endogenous flora. The split-thickness skin graft donor site, characterized by partial-thickness skin removal, exposes underlying dermis and subcutaneous tissue, creating an environment susceptible to bacterial colonization. Common pathogens include Staphylococcus aureus and Streptococcus species, which can invade the wound through breaks in the skin barrier or during the grafting process 1 3 5.

The initial phase involves bacterial adherence and colonization, facilitated by devitalized tissue and local inflammatory responses. Subsequently, the host immune system initiates an inflammatory cascade, recruiting neutrophils and macrophages to clear pathogens. However, if the immune response is overwhelmed or compromised, this can lead to persistent inflammation, tissue necrosis, and the clinical manifestation of infection. Factors such as poor wound hygiene, prolonged surgery time, and underlying systemic conditions like diabetes or immunosuppression further exacerbate the risk 1 3 5.

Epidemiology

The incidence of superficial wound infections at donor sites following STSG varies but is generally reported to range from 1% to 10% 1 7. These infections disproportionately affect patients with compromised immune systems, those undergoing multiple grafting procedures, and those in settings with suboptimal aseptic techniques. Geographic and socioeconomic factors can also influence infection rates, with resource-limited settings often reporting higher incidences due to less stringent infection control measures 7. Trends suggest an increasing awareness and implementation of stringent prophylactic measures, potentially leading to a decline in infection rates over time, though robust longitudinal data are limited 1 7.

Clinical Presentation

Superficial wound infections typically present with localized signs including erythema, warmth, tenderness, and purulent drainage at the donor site. Patients may report subjective symptoms such as pain, swelling, and a sensation of heaviness. Early detection often relies on clinical judgment, but delayed healing and failure of the graft to take can also signal infection. Red-flag features include systemic symptoms like fever, malaise, and rapid progression of local signs, which necessitate urgent evaluation and intervention 1 5 7.

Diagnosis

Diagnosis of superficial wound infections involves a combination of clinical assessment and laboratory testing. Key diagnostic criteria include:

Clinical Signs: Erythema, warmth, pain, and purulent discharge at the donor site 1 5.

Laboratory Tests:

- Wound Culture: Obtain for definitive identification of pathogens and antibiotic sensitivity 1 3. - Leukocyte Count: Elevated white blood cell count may indicate systemic inflammation 1 3. - Gram Stain: Rapid assessment of bacterial presence in wound exudate 1 3.

Differential Diagnosis:

Cellulitis: Distinguished by more diffuse erythema and swelling without purulent drainage 1 5.

Allergic Reactions: Often presents with urticaria, pruritus, and systemic symptoms without purulent discharge 1 5.

Graft Rejection: Characterized by progressive redness, firmness, and eventual graft failure without purulent discharge 1 5.

Management

Initial Management

Wound Care:

- Debridement: Remove necrotic tissue and cleanse the wound with sterile saline 1 5. - Dressing Changes: Use sterile dressings, potentially incorporating negative pressure wound therapy (NPWT) for severe cases 8 10.

Antibiotics:

- Empiric Therapy: Initiate broad-spectrum antibiotics targeting S. aureus and Streptococcus species (e.g., cephalosporins or clindamycin) 1 3. - Adjustment Based on Culture Results: Tailor antibiotic therapy according to wound culture and sensitivity results 1 3.

Secondary and Refractory Management

Advanced Wound Care Products:

- Biodegradable Matrices: Consider matrices like NovoSorb® for complex wounds to promote granulation tissue formation 6. - Growth Factors: Use of autologous platelet gel or fibrin sealants to enhance healing (Evidence: Moderate) 3.

Surgical Intervention:

- Re-grafting: In cases of graft failure, consider re-grafting after infection resolution 1 5. - Abscess Drainage: If abscess formation occurs, surgical drainage may be necessary 1 5.

Contraindications:

Severe Allergic Reactions: Avoid certain antibiotics or dressings known to cause allergic responses 1 5.

Complications

Deep Infection: Progression to deeper tissue involvement requiring more extensive surgical intervention 1 5.

Graft Failure: Impaired graft take and integration, necessitating re-grafting 1 5.

Systemic Infections: Rare but serious complications including sepsis, particularly in immunocompromised patients 1 5.

Referral Triggers: Persistent fever, systemic symptoms, or failure to respond to initial treatment warrant specialist referral 1 5.

Prognosis & Follow-up

The prognosis for superficial wound infections is generally favorable with prompt and appropriate management. Key prognostic indicators include early diagnosis, effective antibiotic therapy, and meticulous wound care. Follow-up intervals typically include:

Initial Monitoring: Daily assessment for the first week post-diagnosis 1 5.

Subsequent Visits: Weekly evaluations until signs of healing stabilize 1 5.

Long-term Monitoring: Regular check-ups to ensure complete healing and prevent recurrence 1 5.

Special Populations

Immunocompromised Patients: Higher risk of infection and slower healing; require closer monitoring and possibly prophylactic measures 1 5.

Elderly Patients: Increased susceptibility to complications; wound care should be meticulous and consider comorbidities 1 5.

Diabetic Patients: Higher incidence of infections due to impaired wound healing; tight glycemic control is essential 1 5.

Key Recommendations

Prompt Wound Assessment: Regularly inspect donor sites for signs of infection (Evidence: Strong) 1 5.

Early Antibiotic Therapy: Initiate broad-spectrum antibiotics upon suspicion of infection (Evidence: Strong) 1 3.

Wound Debridement: Perform thorough debridement of necrotic tissue (Evidence: Strong) 1 5.

Negative Pressure Wound Therapy (NPWT): Consider NPWT for severe or complex infections (Evidence: Moderate) 8 10.

Culturing and Sensitivity Testing: Obtain wound cultures to guide targeted antibiotic therapy (Evidence: Strong) 1 3.

Optimize Wound Care Products: Utilize advanced wound care matrices for complex cases (Evidence: Moderate) 6.

Monitor for Systemic Symptoms: Early referral for systemic symptoms like fever or malaise (Evidence: Moderate) 1 5.

Follow-up Care: Schedule regular follow-up visits to monitor healing progress (Evidence: Moderate) 1 5.

Consider Growth Factor Therapy: Use autologous platelet gel for enhanced healing in refractory cases (Evidence: Moderate) 3.

Manage Comorbidities: Address underlying conditions like diabetes and immunosuppression to improve outcomes (Evidence: Moderate) 1 5.

References

Showing 100 priority papers (full text preferred, most recent first) of 106 indexed.

1 Adil F, Memon MA, Khan FAA, Awan A, Siddiqui SU, Piprani FZ et al.. Efficacy of topical heparin spray on donor site wound healing after split thickness skin grafting. Scientific reports 2025. link 2 Ziolkowski N, Milkovich J, Ahmad J, Benakopoulos E, Lista F, Chbat T et al.. Same-Day Discharge Ambulatory Surgery Centers: The Importance of Preoperative Workup for Aesthetic Surgery Patients. Aesthetic surgery journal 2025. link 3 Wu Y, Peng G, Wang Y, Chen J, Zhang B, Tang J et al.. Clinical efficacy of blood derivatives on wound healing: A systematic review and network meta-analysis. International wound journal 2024. link 4 Legemate CM, Kwa KAA, Goei H, Pijpe A, Middelkoop E, van Zuijlen PPM et al.. Hydrosurgical and conventional debridement of burns: randomized clinical trial. The British journal of surgery 2022. link 5 Niederstätter IM, Schiefer JL, Fuchs PC. Surgical Strategies to Promote Cutaneous Healing. Medical sciences (Basel, Switzerland) 2021. link 6 Li H, Lim P, Stanley E, Lee G, Lin S, Neoh D et al.. Experience with NovoSorb® Biodegradable Temporising Matrix in reconstruction of complex wounds. ANZ journal of surgery 2021. link 7 Maduba CC, Nnadozie UU, Modekwe VI, Nwankwo EU. Comparing hospital stay and patient satisfaction in a resource poor setting using conventional and locally adapted negative pressure wound dressing methods in management of leg ulcers with split skin grafts: a comparative prospective study. The Pan African medical journal 2020. link 8 Norman G, Goh EL, Dumville JC, Shi C, Liu Z, Chiverton L et al.. Negative pressure wound therapy for surgical wounds healing by primary closure. The Cochrane database of systematic reviews 2020. link 9 Alkhalifah MK, Almutairi FSH. Optimising Wound Closure Following a Fasciotomy: A narrative review. Sultan Qaboos University medical journal 2019. link 10 Webster J, Liu Z, Norman G, Dumville JC, Chiverton L, Scuffham P et al.. Negative pressure wound therapy for surgical wounds healing by primary closure. The Cochrane database of systematic reviews 2019. link 11 Barrow J, Divecha H, Board T. Skin closure in arthroplasty surgery: Current practice. International wound journal 2018. link 12 Custis T, Armstrong AW, King TH, Sharon VR, Eisen DB. Effect of Adhesive Strips and Dermal Sutures vs Dermal Sutures Only on Wound Closure: A Randomized Clinical Trial. JAMA dermatology 2015. link 13 Bredow J, Oppermann J, Hoffmann K, Hellmich M, Wenk B, Simons M et al.. Clinical trial to evaluate the performance of a flexible self-adherent absorbent dressing coated with a soft silicone layer compared to a standard wound dressing after orthopedic or spinal surgery: study protocol for a randomized controlled trial. Trials 2015. link 14 Schilling JA. Advances in knowledge related to wounding, repair, and healing: 1885-1984. Annals of surgery 1985. link 15 Reiter HJ, Andersen C. The use of near-infrared spectroscopy in assessment of viability and monitoring of healthy trajectories in skin tears. Wounds : a compendium of clinical research and practice 2025. link 16 Prasad S, Lynch CG, Barrett C, Thaller S. Nonclinical Factors Drive the Majority of 1-Star Yelp Reviews for Plastic Surgeons in 4 Major US Cities. Annals of plastic surgery 2025. link 17 Lemons M, Vance DT, Mitchell A, Geoffroy HG, Helton EM, Kilgore LJ. Redrawing the surgical line: The role of female surgeon mentorship in shaping female medical students' perceptions of surgery. American journal of surgery 2025. link 18 Hong DY, Danford NC, Wu CH, Kadiyala RK. Fasciocutaneous Advancement Flap for Anterior Open Wounds After Primary and Revision Total Knee Arthroplasty. Journal of surgical orthopaedic advances 2025. link 19 Wang X, Li Y, Liu T, Liu C, Lv Y, Liu D et al.. The Effectiveness of PELNAC. Aesthetic plastic surgery 2025. link 20 Stanton EW, Manasyan A, Roohani I, Wolfe E, Daar DA, Carey JN. Sociodemographic Status Impacts Ambulatory Outcomes in Lower Extremity Flap Reconstruction. Journal of reconstructive microsurgery 2025. link 21 Potter CT, Maloney ME, Riopelle AM, Fudem GM, Schanbacher CF. Impact of Needle Design and Suture Gauge on Tissue Tearing During Skin Suturing: A Comparative Analysis. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2025. link 22 Witt EE, Jogerst K, Wojcik BM, Mansur A, Mullen JT, Petrusa ER et al.. Patient satisfaction with women vs men surgical interns and senior residents. American journal of surgery 2024. link 23 Krauß S, Illg C, Held M, Daigeler A, Eisler W. A quantitative analysis of microcirculation during healing of split-thickness skin grafts in standardized full-thickness wounds. Wounds : a compendium of clinical research and practice 2024. link 24 Taba G, Ceccato V, Fernandes O, Michel S, Darrigues L, Girard N et al.. Impact of ERAS in breast reconstruction with a latissimus dorsi flap, compared to conventional management. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2023. link 25 Kim PJ, Hircock C, Huynh MNQ, Gallo L, Thoma A. The appropriateness and quality of patient-reported outcome measures (PROMs) in plastic surgery randomized controlled trials: A systematic review. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2023. link 26 Bovis JL, Walsh K, King IC, Hallam MJ, Gilbert PM. Estimation of wound surface area: an evaluation of medical professionals' assessment in a plastic surgery unit. Journal of wound care 2023. link 27 Premkumar A, Grubel J, Ondeck NT, Koo A, Chiu YF, Blevins JL et al.. Wound Complications Are Affected by Different Skin Closure Methods in Primary Hip and Knee Arthroplasty. The Journal of arthroplasty 2023. link 28 Wu X, Chen J, Zhou A, Zhao Y, Tian Z, Zhang Y et al.. Light-Activated Chemically Reactive Fibrous Patch Revolutionizes Wound Repair Through the Prevention of Postoperative Adhesion. Nano letters 2023. link 29 Takaya A, Higashino T, Oshima A, Fukunaga Y, Ohba J, Suzuki A et al.. Clinical assessment of early mobilization after head and neck free flap reconstruction: A retrospective case-control study. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2022. link 30 White-Dzuro CG, Nguyen L, Glassman GE, Drolet BC. Patient Perspectives on Resident Involvement in Plastic Surgery. Annals of plastic surgery 2022. link 31 Chim H. Suprafascial radiological characteristics of the superthin profunda artery perforator flap. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2022. link 32 Hahn HM, Kim TW, Thai DQ, Lee IJ. Impact of perioperative vasopressors on lower extremity free flap reconstruction. Microsurgery 2022. link 33 Seaton K, Mullens D, Barr J, Hull E, Averitte R. Use of Amniotic Tissue-Derived Allografts Post-Mohs Micrographic Surgery: A Preliminary Study Assessing Wound Closure Rate. Wounds : a compendium of clinical research and practice 2021. link 34 O'Malley P, McDonnell C. Negative pressure wound therapy-two novel approaches to healing dehisced vascular bypass wounds. Journal of wound care 2021. link 35 Desvigne MN, Berman ML, Villanueva DS, Fawcett K, Aragon J, Wardman AL et al.. Initial Experience Using Disposable Negative Pressure Wound Therapy for Closed Incisions Following Outpatient Wound Reconstruction. Wounds : a compendium of clinical research and practice 2020. link 36 Morrow BT. Plastic Surgery Techniques for Wound Coverage. The Surgical clinics of North America 2020. link 37 Park JW, Moon J, Lee KT, Woo KJ, Oh H, Jeon BJ et al.. Comparison of surgical outcomes of free flap reconstructions performed by expert microsurgeons and trainees who completed a structured microsurgical training program in a teaching hospital. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2020. link 38 Winter E, Glauser G, Caplan IF, Goodrich S, McClintock SD, Kovach SJ et al.. The LACE+ Index as a Predictor of 30-Day Patient Outcomes in a Plastic Surgery Population: A Coarsened Exact Match Study. Plastic and reconstructive surgery 2020. link 39 Orlandini V, Peyrot I, Magis Q, Lebas D, Tranchant P, Bailly JY et al.. A New Hydrocellular Wound Dressing Used After Dermatologic Surgery: Dermatologic Surgeons' and Patients' Perceptions. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2020. link 40 Anitua E, Pino A. The Management of Postsurgical Wound Complications with Plasma Rich in Growth Factors: A Preliminary Series. Advances in skin & wound care 2020. link 41 Anis HK, Mahmood BM, Klika AK, Mont MA, Barsoum WK, Molloy RM et al.. Hospital Volume and Postoperative Infections in Total Knee Arthroplasty. The Journal of arthroplasty 2020. link 42 Shukla SK, Sharma AK, Gupta V, Yashavarddhan MH. Pharmacological control of inflammation in wound healing. Journal of tissue viability 2019. link 43 Stoecker A, Blattner CM, Howerter S, Fancher W, Young J, Lear W. Effect of Simple Interrupted Suture Spacing on Aesthetic and Functional Outcomes of Skin Closures. Journal of cutaneous medicine and surgery 2019. link 44 Nagata T, Miura K, Homma Y, Fukamizu H. Comparison between Negative-Pressure Fixation and Film Dressing in Wound Management after Tissue Expansion: A Randomized Controlled Trial. Plastic and reconstructive surgery 2018. link 45 Finlayson K, Teleni L, McCarthy AL. Topical Opioids and Antimicrobials for the Management of Pain, Infection, and Infection-Related Odors in Malignant Wounds: A Systematic Review. Oncology nursing forum 2017. link 46 Carli AV, Spiro S, Barlow BT, Haas SB. Using a non-invasive secure skin closure following total knee arthroplasty leads to fewer wound complications and no patient home care visits compared to surgical staples. The Knee 2017. link 47 McBride KE, Young JM, Bannon PG, Solomon MJ. Assessing surgical research at the teaching hospital level. ANZ journal of surgery 2017. link 48 Brewer JD, Gonzalez AB, Baum CL, Arpey CJ, Roenigk RK, Otley CC et al.. Comparison of Sterile vs Nonsterile Gloves in Cutaneous Surgery and Common Outpatient Dental Procedures: A Systematic Review and Meta-analysis. JAMA dermatology 2016. link 49 Henderson PW, Landford W, Gardenier J, Otterburn DM, Rohde CH, Spector JA. A Simple, Visually Oriented Communication System to Improve Postoperative Care Following Microvascular Free Tissue Transfer: Development, Results, and Implications. Journal of reconstructive microsurgery 2016. link 50 de Meijer VE, Knops SP, van Dongen JA, Eyck BM, Vles WJ. The fate of research abstracts submitted to a national surgical conference: a cross-sectional study to assess scientific impact. American journal of surgery 2016. link 51 Ayandipo OO, Adigun TA, Afuwape OO, Idowu OK. Comparison of postoperative pain in diathermy and conventional scalpel Skin incision after mastectomy in Ibadan, Nigeria. African journal of medicine and medical sciences 2015. link 52 Held M, Rothenberger J, Tolzmann D, Petersen W, Schaller HE, Rahmanian-Schwarz A. Alteration of Biomechanical Properties of Skin During the Course of Healing of Partial-thickness Wounds. Wounds : a compendium of clinical research and practice 2015. link 53 Klosterman T, Siu E, Tatum S. Free flap reconstruction experience and outcomes at a low-volume institution over 20 years. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2015. link 54 Akhtar S, Ahmad I, Khan AH, Khurram MF. Modalities of soft-tissue coverage in diabetic foot ulcers. Advances in skin & wound care 2015. link 55 Chao AH, Lamp S. Current approaches to free flap monitoring. Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses 2014. link 56 Neuhaus SJ. Australia's female military surgeons of World War I. ANZ journal of surgery 2013. link 57 Dignon A, Arnett N. Which is the better method of wound closure in patients undergoing hip or knee replacement surgery: sutures or skin clips?. Journal of perioperative practice 2013. link 58 Limthongkul B, Samie F, Humphreys TR. Assessment of postoperative pain after Mohs micrographic surgery. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2013. link 59 Morales-Burgos A, Loosemore MP, Goldberg LH. Postoperative wound care after dermatologic procedures: a comparison of 2 commonly used petrolatum-based ointments. Journal of drugs in dermatology : JDD 2013. link 60 Wigger-Alberti W, Stauss-Grabo M, Grigo K, Atiye S, Williams R, Korting HC. Efficacy of a tyrothricin-containing wound gel in an abrasive wound model for superficial wounds. Skin pharmacology and physiology 2013. link 61 Córdoba S, Caballero I, Navalón R, Martínez-Sánchez D, Martínez-Morán C, Borbujo J. Analysis of operating room activities in the dermatology department at Hospital Universitario de Fuenlabrada (2005-2010). Actas dermo-sifiliograficas 2013. link 62 Tong T, Simpson DJ. Free skin grafts for immediate wound coverage following tumour resection from the canine distal limb. The Journal of small animal practice 2012. link 63 Thakkar SC, Mears SC. Visibility of surgical site marking: a prospective randomized trial of two skin preparation solutions. The Journal of bone and joint surgery. American volume 2012. link 64 Amsellem P. Complications of reconstructive surgery in companion animals. The Veterinary clinics of North America. Small animal practice 2011. link 65 Yanai H, Budovsky A, Tacutu R, Fraifeld VE. Is rate of skin wound healing associated with aging or longevity phenotype?. Biogerontology 2011. link 66 Bloemen MC, van Zuijlen PP, Middelkoop E. Reliability of subjective wound assessment. Burns : journal of the International Society for Burn Injuries 2011. link 67 Henry SL, Weinfeld AB, Sharma SK, Kelley PK. External doppler monitoring of free flaps through negative pressure dressings. Journal of reconstructive microsurgery 2011. link 68 Lucas VS, King AW. Wound care for the plastic surgery nurse. Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses 2010. link 69 Marquez TT, Christoforidis D, Abraham A, Madoff RD, Rothenberger DA. Wound infection following stoma takedown: primary skin closure versus subcuticular purse-string suture. World journal of surgery 2010. link 70 Becker ST, Rennekampff HO, Alkatout I, Wiltfang J, Terheyden H. Comparison of vacuum and conventional wound dressings for full thickness skin grafts in the minipig model. International journal of oral and maxillofacial surgery 2010. link 71 Kerrigan CL, Homa K. Evaluation of a new wound closure device for linear surgical incisions: 3M Steri-Strip S Surgical Skin Closure versus subcuticular closure. Plastic and reconstructive surgery 2010. link 72 Medeiros JL, Nicolau RA, Nicola EM, dos Santos JN, Pinheiro AL. Healing of surgical wounds made with lambda970-nm diode laser associated or not with laser phototherapy (lambda655 nm) or polarized light (lambda400-2000 nm). Photomedicine and laser surgery 2010. link 73 Yang CS, Yeh CH, Chen MY, Jiang CH, Su FC, Yeh ML. Mechanical evaluation of the influence of different suture methods on temporal skin healing. 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Original source

[1]
Efficacy of topical heparin spray on donor site wound healing after split thickness skin grafting. — Adil F, Memon MA, Khan FAA, Awan A, Siddiqui SU, Piprani FZ et al. Scientific reports (2025)
[2]
Same-Day Discharge Ambulatory Surgery Centers: The Importance of Preoperative Workup for Aesthetic Surgery Patients. — Ziolkowski N, Milkovich J, Ahmad J, Benakopoulos E, Lista F, Chbat T et al. Aesthetic surgery journal (2025)
[3]
Clinical efficacy of blood derivatives on wound healing: A systematic review and network meta-analysis. — Wu Y, Peng G, Wang Y, Chen J, Zhang B, Tang J et al. International wound journal (2024)
[4]
Hydrosurgical and conventional debridement of burns: randomized clinical trial. — Legemate CM, Kwa KAA, Goei H, Pijpe A, Middelkoop E, van Zuijlen PPM et al. The British journal of surgery (2022)
[5]
Surgical Strategies to Promote Cutaneous Healing. — Niederstätter IM, Schiefer JL, Fuchs PC Medical sciences (Basel, Switzerland) (2021)
[6]
Experience with NovoSorb® Biodegradable Temporising Matrix in reconstruction of complex wounds. — Li H, Lim P, Stanley E, Lee G, Lin S, Neoh D et al. ANZ journal of surgery (2021)
[7]
Comparing hospital stay and patient satisfaction in a resource poor setting using conventional and locally adapted negative pressure wound dressing methods in management of leg ulcers with split skin grafts: a comparative prospective study. — Maduba CC, Nnadozie UU, Modekwe VI, Nwankwo EU The Pan African medical journal (2020)
[8]
Negative pressure wound therapy for surgical wounds healing by primary closure. — Norman G, Goh EL, Dumville JC, Shi C, Liu Z, Chiverton L et al. The Cochrane database of systematic reviews (2020)
[9]
Optimising Wound Closure Following a Fasciotomy: A narrative review. — Alkhalifah MK, Almutairi FSH Sultan Qaboos University medical journal (2019)
[10]
Negative pressure wound therapy for surgical wounds healing by primary closure. — Webster J, Liu Z, Norman G, Dumville JC, Chiverton L, Scuffham P et al. The Cochrane database of systematic reviews (2019)
[11]
Skin closure in arthroplasty surgery: Current practice. — Barrow J, Divecha H, Board T International wound journal (2018)
[12]
Effect of Adhesive Strips and Dermal Sutures vs Dermal Sutures Only on Wound Closure: A Randomized Clinical Trial. — Custis T, Armstrong AW, King TH, Sharon VR, Eisen DB JAMA dermatology (2015)
[13]
Clinical trial to evaluate the performance of a flexible self-adherent absorbent dressing coated with a soft silicone layer compared to a standard wound dressing after orthopedic or spinal surgery: study protocol for a randomized controlled trial. — Bredow J, Oppermann J, Hoffmann K, Hellmich M, Wenk B, Simons M et al. Trials (2015)
[14]
Advances in knowledge related to wounding, repair, and healing: 1885-1984. — Schilling JA Annals of surgery (1985)
[15]
The use of near-infrared spectroscopy in assessment of viability and monitoring of healthy trajectories in skin tears. — Reiter HJ, Andersen C Wounds : a compendium of clinical research and practice (2025)
[16]
Nonclinical Factors Drive the Majority of 1-Star Yelp Reviews for Plastic Surgeons in 4 Major US Cities. — Prasad S, Lynch CG, Barrett C, Thaller S Annals of plastic surgery (2025)
[17]
Redrawing the surgical line: The role of female surgeon mentorship in shaping female medical students' perceptions of surgery. — Lemons M, Vance DT, Mitchell A, Geoffroy HG, Helton EM, Kilgore LJ American journal of surgery (2025)
[18]
Fasciocutaneous Advancement Flap for Anterior Open Wounds After Primary and Revision Total Knee Arthroplasty. — Hong DY, Danford NC, Wu CH, Kadiyala RK Journal of surgical orthopaedic advances (2025)
[19]
The Effectiveness of PELNAC — Wang X, Li Y, Liu T, Liu C, Lv Y, Liu D et al. Aesthetic plastic surgery (2025)
[20]
Sociodemographic Status Impacts Ambulatory Outcomes in Lower Extremity Flap Reconstruction. — Stanton EW, Manasyan A, Roohani I, Wolfe E, Daar DA, Carey JN Journal of reconstructive microsurgery (2025)
[21]
Impact of Needle Design and Suture Gauge on Tissue Tearing During Skin Suturing: A Comparative Analysis. — Potter CT, Maloney ME, Riopelle AM, Fudem GM, Schanbacher CF Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (2025)
[22]
Patient satisfaction with women vs men surgical interns and senior residents. — Witt EE, Jogerst K, Wojcik BM, Mansur A, Mullen JT, Petrusa ER et al. American journal of surgery (2024)
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