A Secret of Plastic Surgeons

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I just saw yet another patient with an open wound and instructions to keep the area dry with clean gauze. I will now reveal to you a long kept secret that will probably expel me from the American Society of Plastic Surgeons. Just Joking. We, as plastic surgeons, have always viewed ourselves as teachers not just technicians, and therefore have been trying to teach our colleagues in other branches of surgery and medicine our experience with healing. We are the ones that are called upon to close wounds that no other service can heal. We arrive and miraculously patients’ wounds heal within days. The secret…… none really, just common sense. The internal environment of our body (that is anything below the level of the superficial skin) is moist! Therefore, when trying to heal an open wound keeping the environment moist will provide the normal biologic rapid cascade that leads to contraction and epithelialization better known as a healed wound. Wounds that are kept dry only form a biologic crust that was once live tissue. A layer of live tissue is killed every time an open wound is allowed to dry. Healing is inhibited by a scab of dead tissue that is a wonderful breeding- ground for bacteria. Wounds that are kept moist will practically heal themselves if allowed. So next time a friend gets hurt on vacation….. cleanse the wound with soap and water, apply ointment liberally as often as necessary to moisturize and you too will be hailed as a hero. Psst.. don’t tell anyone!