The comprehensive understanding of the biology of wound healing remains an elusive goal. Perturbations in healing, manifested as either wound failure or exuberant fibroplastic responses, account for more than 50% of cases presented at surgical morbidity and mortality conferences as well as for huge health dollar expenditures.
Historically, surgeons have always been interested in the results of their surgical interventions. Mainly, retrospective studies have been carried out to examine wound outcomes and to attempt to identify clinical factors that are associated with impaired healing responses. Typical wounds studied include skin incisions, anastomoses, bone fractures, tendon repairs, and cutaneous burns. Most frequently, age, American Society of Anesthesiologists status, diabetes, use of steroids or other immunosuppressive agents, and impaired circulation have been associated with poor outcomes.1