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Evidence-Based Medicine: Wound Closure

Buchanan, Patrick J. M.D.; Kung, Theodore A. M.D.; Cederna, Paul S. M.D.

Plastic and Reconstructive Surgery: December 2014 - Volume 134 - Issue 6 - p 1391–1404
doi: 10.1097/PRS.0000000000000720
MOC-CME: Original Articles

Learning Objectives: After reading this article, the participant should be able to: 1. Describe various wound closure techniques available to the modern plastic surgeon, including the indications and contraindications of each. 2. Explain the fundamental concepts of wound healing as it relates to reconstruction. 3. Understand the role of commonly used reconstructive adjuncts such as negative-pressure wound therapy, dermal substitutes, and tissue expansion. 4. Assess the important patient factors that may influence the strategy for surgical wound closure.

Summary: Successful wound closure requires a comprehensive approach that includes consideration of suitable surgical techniques and critical patient factors. A clear understanding of key concepts such as wound healing, flap design, and patient risk assessment is imperative to a favorable outcome. In this Maintenance of Certification/Continuing Medical Education article, the reader is provided a summary of the available surgical options for wound closure and a discussion of the algorithm used to choose the most appropriate reconstructive strategy.

Ann Arbor, Mich.

From the Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan Health System.

Received for publication March 27, 2014; accepted June 2, 2014.

Disclosure: The authors have no financial interest in any of the products or devices mentioned in this article. This project did not require any sources of funding.

Paul S. Cederna, M.D., Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan Health System, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, Mich. 48109,

©2014American Society of Plastic Surgeons