ABSTRACT
In order to understand the pathophysiology of the traumatized lower extremity, one must first understand the classical phases of wound healing: inflammatory phase, repair phase, and maturation phase. The inflammatory phase of wound healing is initiated by injury: be it trauma, infection, or antigen–antibody reaction; and is nonspecific in response. Although wound strength continues to increase, the net collagen production slows down because synthesis and degradation come into equilibrium around six weeks postinjury. In addition to the direct limb damage from high-energy trauma, traumatic injuries involving burns, cold injury, pressure injury, and radiation may result in the development of wounds. The debridement of necrotic tissue by either surgical or nonsurgical means is an essential component of wound care. Adequate tissue oxygenation is necessary for all phases of wound healing. The diversity of growth factors and types of chronic wound suggest that these factors have potential as new treatments if patients’ individual requirements can be identified.
