Factors influencing wound healing
Until comparatively recently it was considered to be self-evident that wound healing and infection were both parts of the same process. The words 'laudable pus' speak for themselves. De Chauliac and Pare were amongst the first generation of surgeons who were dissatisfied with this concept, and showed that healing could be achieved without infection if better treatment was applied to the wound. Semmf'lweis and Lister clearly showed that the two processes were distinct, and thus laid the basis for modern surgery. Nowadays the roles are reversed, and there appears to be a real danger of wound healing without infection being taken for granted. Many are unaware that most complications can be prevented, because they do not have satisfactory knowledge of the healing process. A surgeon-to-be must therefore become conversant with the basic principles of this process. He must accurately assess the damage caused by the wound and the body's capacity for repairing this damage. He must learn to allow nature to take its course, and only to interfere when nature threatens to 'go astray'. But, first of all, he must begin at the beginning and realize that three important phases in the healing process can be differentiated: a reaction phase, a regeneration phase, and a remodelling phase.