The Influence of Preoperative Interventions on Postoperative Surgical Wound Healing in Patients Without Risk Factors: A Systematic Review

Public Knowledge About How Common Chronic Diseases Affect Wound Healing Postoperatively in Aseer Region

Background

Wound healing has classically been described to occur in three phases, regardless of the mechanism of injury. These phases are the inflammatory, proliferative, and remodeling phases. Chronic diseases adversely affect the wound healing process, and more needs to be done for different policies, such as adjustment of drug therapy, diet, or behavior to help rapid wound healing. Diabetes, auto-immune diseases, obesity, malnutrition, cardiovascular disease, chronic renal disease, and cancers are the frequent co-morbidities affecting wound healing.

Aim

To assess the public knowledge about how common chronic diseases affect wound healing postoperatively in Aseer Region.

Methodology

A descriptive cross-sectional study targeting the general population living in the Aseer region for at least a year. Data were collected using a pre-structured electronic questionnaire initiated by the researchers after an intense literature review and experts’ consultation. The study questionnaire covered participants’ data, smoking and medical history, surgical history, and participant knowledge items. A questionnaire was used as a digital survey and distributed to all participants in a private and anonymous process.

Results

A total of 502 participants completed the study questionnaire. Participants' ages ranged from 18 to 60 years, with a mean age of 34.6 ± 12.9 years old. A total of 294 (58.6%) participants were males, and 341 (67.9%) were university graduates. Exact 430 (85.7%) know that Supervision and control of Diabetes Mellitus help in wound healing, 369 (73.5%) reported that Chronic diseases delay wound healing, and 449 (89.4%) think that commitment to therapeutic and preventive plans before and after any surgical procedure contributing in rapid wound healing for chronic diseases patients. As for the effect of chronic diseases on a surgical wound, 320 (63.7%) reported delayed wound healing, 241 (48%) knew it may increase the infection, and 186 (37.1%) reported it might Decrease blood supply to the site of a wound.

Conclusions

In conclusion, the study revealed that more than half of the population in Aseer regions were knowledgeable regarding the effect of chronic diseases on post-optative wound healing, especially for the benefit of a commitment to therapeutic and preventive plans before and after any surgical procedure.

N-Acetylcysteine Added to Local Anesthesia Reduces Scar Area and Width in Early Wound Healing-An Animal Model Study

The aim of the study was to evaluate if a pre-incisional N-acetylcysteine (NAC) treatment altered the process of wound healing in a rat model. The dorsal skin of 24 Sprague-Dawley rats was incised in six locations. Before the incisions were made, skin was injected either with lidocaine and epinephrine (one side) or with these agents supplemented with 0.015%, 0.03%, or 0.045% NAC (contralaterally). Photographic documentation of the wound healing process was made at 11 time points. Rats were sacrificed 3, 7, 14, or 60 days after incision to excise scars for histological analysis. They included: Abramov scale scoring, histomorphometry analysis, and collagen fiber arrangement assessment. Skin pretreated with 0.03% NAC produced the shortest scars at all analyzed time points, though this result was statistically insignificant. At this NAC concentration the scars had smaller areas on the third day and were narrower on the day 4 compared with all the other groups (p < 0.05). On day 7, at the same concentration of NAC, the scars had a higher superficial concentration index (p = 0.03) and larger dermal proliferation area (p = 0.04). NAC addition to pre-incisional anesthetic solution decreased wound size and width at an early stage of scar formation at all concentrations; however, with optimal results at 0.03% concentration.