Wound Practice and Research Volume 20 Number 4 – November 2012 174A history of materials and practices for wound managementDaunton C, Kothari S, Smith L & Steele DMs Carla Daunton The Mawson Institute, University of South Australia, Mawson Lakes Campus, Mawson Lakes, Adelaide, SADr Sherry KothariThe Mawson Institute, University of South Australia, Mawson Lakes Campus, Mawson Lakes, Adelaide, SADr Louise SmithThe Mawson Institute, University of South Australia, Mawson Lakes Campus, Mawson Lakes, Adelaide, SADr David Steele*The Mawson Institute, University of South Australia, Mawson Lakes Campus, Mawson Lakes, Adelaide, SA Email david.steele@unisa.edu.au*Corresponding authorAbstractFrom a spiritual vessel to an extremely intricate system, the human body has slowly become less mysterious to us. As civilisation and technology evolved, the teachings, methodology and materials used in the care of both acute and chronic wounds have grown, both in sophistication and in variety. This article provides a brief overview of some of the methods employed by healers throughout history to enhance the wound healing process as well as an overview of current materials available.Keywords: wound dressings, healing, history, smart dressing.Upon wounding, damage occurs to the epidermis, the local vasculature and possibly the dermis and underlying tissues, depending on the depth of the wound. This creates a potential threat to the integrity of the organism as it allows entry by pathogens, as well as blood loss 1,2 . Wounding sets off an intricate cascade of biological events that stimulates the healing response 3 and results in the restoration of the barrier function of skin, destruction and removal of any invading pathogens and foreign debris, restoration of the local vasculature and tissues and, finally, remodelling of the injury site to more closely resemble uninjured tissue. Wound healing concludes with up to 80% original tensile strength being restored to the site 1,4-6 . Wound healing involves four tightly regulated overlapping phases: haemostasis (formation of the fibrin clot); inflammation (the body’s immune response); proliferation or re-epithelialisation (cell migration and wound closure); and remodelling (reorganisation of the disorganised extra cellular matrix to more closely resemble uninjured tissue) as shown in Figure 1.While modern investigations have provided much information regarding the wound healing process 7,8 , the obvious indicators of healing have been known since ancient times, along with contraindications such as infection and chronicity. In order to ensure a wound healed properly, a wide range of practices and materials were used throughout history. These interventions were in line with the perceived best practice of the day, some examples of which are presented below.Materials used in wound care – ancient historyThe earliest known record of the treatment of wounds was found on clay tablets of Mesopotamian origin from about 2500 BCE 9 . Wound care was thought to have come about through trial and error, with primitive cultures employing age-old techniques and wisdom 9 . Wound care in ancient IntroductionThroughout history, from the ridiculous to the ingenious, various interventions have been utilised to enhance healing in acute wounds and to overcome the unique challenges posed by chronic wounds. As medicine shifted from the realm of the spiritual to the scientific, so did the need to understand the outcomes of medical intervention. This review examines the biochemical mechanisms behind wound healing in acute and chronic wounds, and discusses the types of materials used to enhance healing and stave off infection.Daunton C et al. A history of materials and practices for wound management
