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Complex wounds should be managed by a multidisciplinary team, from necrotizing fascitis, through breast reconstruction, to bariatric patients’ ventral hernia. Different surgical options for complex wounds are discussed: hernia repair, negative pressure wound therapy, myocutaneous flaps, and even older therapies such as honey or larvae.
Dr. Younis discusses a few premises to bear in mind when faced with these cases: aggressive debridement for necrotic tissue, making the wound as clean as possible, taking multiple biopsies for microbiology, avoiding leaving vessels exposed, preventive negative wound therapy, using dermal substitutes, using drains to reduce seroma, advice on support garments…
In addition, Dr. Younis advises against wound closure under tension, vertical scars, undermining without leaving perforators vessels, rushing into a close, and being afraid of larvae among other points.