How Skin Heals
Over the years I've been
Dear Hatchling #3:
Remember that patient we did a home visit on back when you were in the office with me? The diabetic amputee with the wound on her (one remaining) leg that wouldn't heal? Well, the good news is that it finally healed. The bad news is that she spilled some hot gravy on her lap while cooking (since she has to do everything from a seated position) and sustained some nasty burns to her thighs a few weeks back.
The really good news is that they were fairly shallow second degree burns. This means that the epidermis was destroyed and sloughed off as blistering, leaving the underlying dermis exposed, painful and vulnerable to infection. All I did was keep the wounds clean and dressed them with an antibacterial/vaseline coated gauze while they healed, which they did beautifully after about two weeks. I went back to see her once or twice a week to make sure they weren't getting infected or anything (they didn't) and were healing ok (they were.)
By the last visit, the wounds had healed completely. If you ran your fingers over the skin, it was smooth; completely epithelialized, but its appearance demonstrated something really cool about the anatomy of the skin that I wished I could show you. Then I thought of a way I could: after asking the patient's permission, I whipped out my trusty cell phone and voila!
Going back to the anatomy of skin, recall that the epidermis doesn't sit flat on top of the dermis like a bedspread. Rather, the dermis has little fingerlike projections that poke up into the epidermis, kind of like a foam "eggcrate" mattress; pink in this picture:
Hope second year is going well for you.
Edited to add Hatchling Index: