ABSTRACT

In nature many wounds heal without the aid of surgical intervention. Superficial wounds such as grazes always heal in this way. There is a skill in deciding which deeper wounds will heal well if they are left open or only partly closed. The cosmetic result of wounds healed by secondary intention varies according to anatomic site often excellent in concave surfaces of the nose, eye, ear and temple. The ability of an open wound to contract is helpful on the scalp because it pulls the hair back together. A skin graft would leave a hairless area and hair-bearing flaps have some limitations. This approach can be used to significant effect but it demands careful explanation to the patient. Lattice closure is another method of partial closure. The principle is that several small wounds will heal at the same pace and therefore speed up overall healing compared with one big wound.