History of wound care
From Wikipedia, the free encyclopedia
The history of wound care spans from prehistory to modern medicine. As wounds naturally heal by themselves, regardless of whether recovery from the scar or recovery from lost body tissue was a possibility, hunter-gatherers would have noticed several factors and certain herbal remedies would speed up or assist the process, especially if it was grievous. In ancient history, this was followed by the realisation of the necessity of hygiene and the halting of bleeding, where wound dressing techniques and surgery developed. Eventually the germ theory of disease also assisted in improving wound care.
Contents |
[edit] Applications in ancient medical practice
The treatment of acute and chronic wounds is an ancient area of specialization in medical practice, with a long and eventful clinical history that traces its origins to ancient Egypt and Greece. The Papyrus of Ebers, circa 1500 B.C., details the use of lint, animal grease, and honey as topical treatments for wounds. The lint provided a fibrous base that promoted wound site closure, the animal grease provided a barrier to environmental pathogens, and the honey served as an antibiotic agent.
The Egyptians believed that closing a wound preserved the soul and prevented the exposure of the spirit to "infernal beings," as was noted in the Berlin papyrus. The Greeks, who had a similar perspective on the importance of wound closure, were the first to differentiate between acute and chronic wounds, calling them "fresh" and "non-healing", respectively. Galen of Pergamum, a Greek surgeon who served Roman gladiators circa 120-201 A.D., made many contributions to the field of wound care. The most important was the acknowledgement of the importance of maintaining wound-site moisture to ensure successful closure of the wound.
There were limited advances that continued throughout the Middle Ages and the Renaissance, but the most profound advances, both technological and clinical, came with the development of microbiology and cellular pathology in the 19th century.
[edit] The 19th century and the discovery of microbes
The first advances in wound care in this era began with the work of Ignaz Philipp Semmelweis, a Hungarian obstetrician who developed sterile surgical procedures, and Louis Pasteur, a French scientist known as the "father of microbiology" for his germ theory of disease. Semmelweis's work was furthered by an English surgeon, Joseph Lister, who began treating his surgical gauze with carbolic acid, known today as phenol, and subsequently dropped his surgical team's mortality rate by 45%. Building on the success of Lister's pretreated surgical gauze, Robert Wood Johnson, co-founder of Johnson & Johnson, began producing gauze and wound dressings treated with iodine. These innovations in wound-site dressings marked the first major steps forward in the field since the advances of the Egyptians and Greeks centuries earlier. The next advances would arise from the development of polymer synthetics for wound dressings and the "rediscovery" of moist wound-site care protocols in the mid 20th century.
[edit] Wound-site dressing: 1950s to present
With advancements in material and tissue sciences, the field of wound-site dressings increased considerably. The ability to bolster wound-site re-epithelialization has been improved as well as improving their clinical efficacy. With the advent of fibrous synthetics of nylon, polyethylene, polypropylene, and polyvinyls in the 1950s, researchers and doctors in the field of wound care are able to significantly accelerate the natural wound healing process. Following the research and articles of George Winter and Howard Maibach in the 1960s, testing the efficacy of synthetic "wet" polymer wound dressings, the 1970s and 1980s represented the dawn of modern wound care treatment. In the 1990s, improvements in composite and hybrid polymers expanded the number of available materials for wound dressings. These improvements, coupled with the developments in tissue engineering, have given rise to a new class of wound dressings called "living skin equivalents." Often cited as a misnomer because they lack key components of whole living skin, "living skin equivalents" represent the future of wound dressings and possess the potential to serve as cellular platforms for the release of growth factors essential for proper wound healing. Other new developements have been focusing on handling patients concerns. Affected individuals often report pain as dominant in their lives[1] and the pain associated with these chronic wounds should be handled as one of the main management priorities. Symptomatic treatment of pain as part of patient centered concerns must go hand-in-hand with treating the underlying etiology or cause of the wound.
[edit] References
- Ovington, L. G. (2002). The evolution of wound management: ancient origins and advances of the past 20 years. Home Healthcare Nurse. 20, p 652-656.
- Sipos, P., Gyory, H., Hagymasi, K., Ondrejka, P., & Blazovics, A. (2004). Special wound healing methods used in ancient egypt and the mythological background. World Journal of Surgery. 28, 211-216
[edit] External links
- Maggot Therapy Project web site at the University of California, Irvine, list of maggot therapy practitioners
- http://www.monarchlabs.com/ suppliers of Medical Maggots™ (disinfected Phaenicia sericata larvae), picture of Medical Maggots™ vial
- http://www.bterfoundation.org/ BioTherapeutics Education and Research Foundation
