Wounds: Traumatic, Septic, Atonic

A wound is any break in the skin on the body. We consider any wound up to six hours old to be fresh. After that, they are aging. Primary surgical treatment should always be performed by then. After this period, wounds can be treated, but the likelihood of complications increases several times over. The main steps in the treatment of any injury is cleaning of the wound, joining both ends, and dressing it with clean material, preventing further infection. These steps should be followed by everyone everywhere in the treatment of wounds, even under primitive conditions. Tap water can be used for washing, and wounds can even be covered with a kitchen napkin or paper towel. Of course, medical attention is to be sought immediately after that. It is necessary for a specialist to make an assessment of how serious the injury is in order to avoid problems that could arise from delayed recognition of injury to a tendon, for example.

Septic wounds are wounds that have been complicated by fresh infection or operative wounds. They need longer and specialized care. When the surgeon determines that he or she can leave the care of such a wound up to the patient, strictly follow all the advice you have received from him or her. Do not hesitate to ask any questions that you may have. Clarifying the condition of the wound will help you to better care for it.

Atonic wounds are usually wounds that spontaneously occur because of the presence of another disease, and these do not have a tendency to heal on their own. Even when provided substantial care by the surgeon and the patient, no significant results are apparent. However, it is important not to give up, but to work with the surgeon and strictly follow his or her advice.


Scars are the result of healed wounds, called ridges, formed during the healing process. Initially, scars are pink, but gradually they fade and become a pale white color. Scarring often occurs after some skin diseases, most acne, and after a violation of the integrity of skin as can occur in burns, injuries, or surgery. If the wound is superficial, a gentle scratch, for example, and affects only the epidermis or surface layer of skin, it can heal without scarring. When the damage is both to the epidermis and dermis, the deep layer of skin, wounds heal with scarring. Then scar tissue forms which replaces the normal skin. The shape and size of the mark depends on the type of damage. The color can change over time. At first, it is pink or red for a few months; after that, almost white. The skin on the scar is different from unaffected skin. It is raised, smooth, and shiny. There are no sweat glands, hair follicles, or fat, but it is still rich in blood vessels and nerves. Therefore, some scars are particularly painful, or the opposite can be true: they can have less sensitivity. The most common scars are atrophic and hypertrophic. Atrophic scars are usually below or at the level of the skin resulting from acne, burns, or frostbite. Hypertrophic scars are red and raised above skin at the site of the injury itself.


Keloids are tumor-like growths of connective scar tissue above the skin. They are a type of hypertrophic scar that extends beyond the site of the injury itself. Keloids, coupled with contractures, occur most frequently after burns. This type of scarring can cover considerable depth and affect the underlying muscles, tendons, and nerves. These characteristics limit the mobility of the affected body region, for example, there may be inability to rotate the neck or inability to move an arm or leg. Only plastic surgeons and surgeons who specialize in the treatment of burns and their consequences can deal with these wounds effectively. This is a specific surgery and is not the area of expertise of a general surgeon.

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