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Wounds have existed since the beginning of time, and records of their nature and treatment are found in the earliest documents. Interestingly, many of these treat ments are now being rediscovered or re-used in modern-day clinical practice. In addition to the diverse nature of treatments that have been suggested as being beneficial for wounds, over many centuries there has been a range of clinicians who have cared for patients with wounds, and in many parts of the world today it is not doctors but other professional colleagues - e. g. nurses or podiatrists - who are the most knowledgeable persons on wounds and wound treatments. Finally, the nature of wounds seen in clinical practice is changing. Increasing destructive power is resulting in more severe injuries occurring in patients involved in conflict. Developments in surgical techniques have enabled new surgical procedures to be offered to patients, but novel and more severe complications can result from such technical advances. In addition, many societies around the world are having to deal with an increasing ageing population, and huge increases in the number of patients suffering from chronic wounds are being seen. In summary, expanding treatment options, diverse groups of clinicians caring for patients and changes in the nature of wounds seen in clinical practice are real issues that have to be faced, and solutions have to be found if patients are to receive optional care for their wounds.

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I Background.- 1 The Pathophysiology of Acute Wounds.- 2 Pathophysiology of Chronic Wounds.- 3 Control of Infection.- 4 Radiotherapy and Wounds.- 5 The Sequelae of the Cutaneous Radiation Syndrome.- II Debridement of Wounds.- 6 Surgical Debridement.- 7 Use of High-Pressure Waterjets in Wound Debridement.- 8 Autolytic Debridement.- III Wound Preparations and Treatment.- 9 Wound-Bed Preparation - Promotion of Granulation Tissue.- 10 Cleansing and Cleansers.- 11 Control of Exudate and Periwound Skin Care.- 12 Topical Negative-Pressure Therapy in Wound Management.- 13 Maggot Debridement.- IV Surgical Interventions in Wounds.- 14 Pre-Operative Requisites.- 15 Dressings for Chronic and Acute Wounds.- 16 Suture Materials and Techniques.- 17 Surgical Incision.- 18 Skin Grafts.- 19 Local and Regional Flaps.- 20 Free Flaps: Interests and Limits.- 21 Post-Operative Management of Skin Graft and Flap.- 22 Dermabrasion and Management of Donor Sites.- V Specific Wound Problems.- 23 Flaps for Upper Limb Reconstruction.- 24 Loss of Soft Tissue in Lower Limbs.- 25 Vacuum-Assisted Closure: Orthopaedic Applications.- 26 Osteomyelitis.- 27 Principles of Surgical Management of War Wounds.- 28 Animal and Human Bite Wounds.- 29 Enterocutaneous Fistulae.- 30 Pilonidal Sinus Disease.- 31 Acne Inversa.- VI Chronic Wound Problems.- 32 Surgery for Arterial Ulcers.- 33 Interventional Radiology for Revascularisation.- 34 Venous Ulcer Surgery.- 35 Diabetic Foot Surgery.- 36 Polyneuropathic Ulcers Surgery.- 37 Pressure-Relieving Systems and Surgery.- 38 Surgical Therapy for Pressure Sores.- VII Burns.- 39 Thermal Burns Management.- 40 Electrical Burns.- 41 Chemical Burns Management.- 42 The Meek-Wall Micrograft Technique.- 43 Skin Substitutes - an Overview of Cultured Epithelia to Treat Wounds.- 44 Skin Equivalents - Integra© in Acute Wounds.- 45 Rehabilitation and Post-Burn Care.- 46 Compression Therapy.- 47 Frostbite: Current Concepts in Pathophysiology and Management.- VIII Treatment of Scaring.- 48 Fundamental Aspects of Extracellular Matrix.- 49 Prevention of Excessive Scar Formation - a Surgical Perspective.- 50 The Non-Surgical Management of Hypertrophic Scars and Keloids.- 51 Surgery of Scars: Hypertrophic, Keloid and Aesthetic Sequellae.- 52 Pathologic Scar Prevention.- 53 Psychological Consequences of Facial Scarring.- IX Future Perspectives in Wound Management.- 54 Prefabrication of Growth Factors and Gene Therapy.- X Conclusions.- 55 Changing Philosophies in Reconstructive Surgery.- XI Appendix.

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