Secondary seam

Secondary seam impose on granulating wound to accelerate its healing. There are early secondary seam imposed after 2-3 weeks after being injured in granulating wound with movable not fixed edges without scars (granulation not removed), and the later the second weld imposed on long-term healing wounds with good granulations and development of scar tissue after excision of the edges and bottom of the wound with all newly formed tissue. The concept of "secondary seam" also includes a bloodless connection methods wound edges sticky plaster or klyovye armbands as a deadline set for early secondary seam. Contraindicated in the imposition of secondary seam at presence in the wound necrotic tissue, inflammation, swelling, extensive pus, regional lymphadenitis, as well as a sharp decline of the power of the patient.
Preparations for the imposition of secondary seam includes effects on wound antibiotics, physical (quartz, UHF) and chemical antiseptics. Impose secondary seam in the operating under strict rules of aseptics, often under local anesthesia. Before the operation wound wash izotoniceski solution of sodium chloride and process around her skin alcoholic iodine solution. The operation takes several scalpels, forceps, haemostatic clips, needle with a large curvature, silk and catgut. Before suturing skin wound pripudrivayut powder penicillin. Sometimes between the seams leave a thin rubber tube for the introduction of penicillin. Successful healing helps stitching the wound edges without tension.
The appearance of pain in the wound after the imposition of secondary seam and rising temperatures indicate a need to check the condition of the wound; if signs abscesses may require immediate removal of stitches and breeding wound edges. When smooth over the sutures are removed on the 10-12-th day.