Wound Surgery This multimedia course is designed to provide podiatrist with high-quality continuing medical education that reflects the spectrum of the podiatric practice. Learning Objectives Understand the general concepts of wound repair surgery. Understand the three usual paradigms of wound closure surgery: simple repairs, grafts, and flaps. Understand the criteria by which these techniques are selected and used to close healthy acute wounds. Understand the difference between acute healthy wounds in which wound healing physiology is intact, versus chronic pathological wounds due to disease, where the wound healing process per se is impaired. Understand why chronic and pathological wounds defy the conventional arts of wound surgery. Understand a general scheme for managing chronic wounds. Become aware of new technology based products which can stimulate wound healing, and which can induce some problem wounds to heal. Become familiar with Integra® collagen-aminoglycan matrix. Understand how it induces histogenesis. Understand how it withstands the adverse conditions which threaten conventional wound surgery. Understand the concept of "in situ tissue engineering", and how Integra permits this practice. Understand how Integra solves the problem of closing those wounds in which flaps are ordinarily indicated but cannot be used. Author Information Marc E. Gottlieb, MD, FACS Diplomate, American Board of Plastic Surgery American Board of Surgery Phoenix, Arizona Overview This course is an overview of wound surgery, the principles and methods of operative wound closure. It will focus first on the established arts of wound repair, and it will then explain new modalities of care based on contemporary technologies. Conventional arts of wound surgery are based on three general methods: simple repairs, grafts, and flaps. Each of these three modalities of wound closure has specific indications, strategies, and techniques. They also have one thing in common: they all depend on a competent wound healing process. If the infrastructure of wound healing is working, then conventional surgery also works, as for the healthy acute wounds that arise due to trauma and surgery. If wound repair physiology is corrupt or suppressed, due to various diseases, then conventional surgery does not work. Successful closure of chronic and pathological ulcers is often impossible with these conventional methods. There are now technology products which can stimulate repair. Most are pharmaceutical or physical modalities designed for topical use. However, one product, a collagen-aminoglycan matrix, can induce histogenesis, even under the adverse conditions of disease. This material is a distinct new paradigm of wound closure surgery - in situ tissue regeneration - and surgeons must work this new mode into their decision schemas. Approved Continuing Education Credit This multimedia course is designed to provide practitioners with high-quality continuing medical education that reflects the spectrum of podiatry practice. This course includes multimedia to emphasize key aspects and provide supplemental learning. This course is approved by the Australasian Podiatry Council for inclusion as Type 2 activities when submitting Accredited Podiatrist Program log-sheets. To earn Accreditation credit you must work through the entire course and complete the quiz. After completing the course and quiz you will be prompted to fill out an evaluation form and registration form (a copy of which you should retain in your records for APP audit documentation). This site uses the Macromedia Flash plugin exclusively. If you do not have the most current version of Flash installed, please click here. Please be patient as some of the courses may take a few minutes to load depending on the speed of your internet connection.