A brief relaxation intervention reduces stress and improves surgical wound healing response: A randomised trial Improving Scar Quality: A Prospective Clinical Study Alleviation of wound pain after surgeries for obstructive sleep apnea. Preoperative bacterial colonization and its influence on postoperative wound infections in plastic surgery. Prospective study of long-term patient perceptions of their skin cancer surgery. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. A randomized, controlled trial comparing long-term cosmetic outcomes of traumatic pediatric lacerations repaired with absorbable plain gut versus nonabsorbable nylon sutures. Treatment of subcutaneous abdominal wound healing impairment after surgery without fascial dehiscence by vacuum assisted closure™ (SAWHI-V.A.C.®-study) versus standard conventional wound therapy: study protocol for a randomized controlled trial Immediate Postoperative Evaluation of the Surgical Wound and Nutritional Evolution after Cheiloplasty The effect of Hypericum perforatum on the wound healing and scar of cesarean. Skin closure of laparotomy wounds: absorbable subcuticular sutures vs. non-absorbable interrupted sutures. Factors affecting the incidence of postoperative wound infection. Are postoperative dressings necessary? Does supplemental perioperative oxygen administration reduce the incidence of wound infection in elective colorectal surgery? Early intervention with non‐ablative fractional laser to improve cutaneous scarring—A randomized controlled trial on the impact of intervention time and fluence levels
Psychological stress has been shown to impair wound healing , but experimental research in surgical patients is lacking . This study investigated whether a brief psychological intervention could reduce stress and improve wound healing in surgical patients . This r and omised controlled trial was conducted at a surgical centre . Inclusion criteria were English-speaking patients over 18 years booked to undergo elective laparoscopic cholecystectomy ; exclusion criteria were cancellation of surgery , medical complications , and refusal of consent . Seventy five patients were r and omised and 15 patients were excluded ; 60 patients completed the study ( 15 male , 45 female ) . Participants were r and omised to receive st and ard care or st and ard care plus a 45-min psychological intervention that included relaxation and guided imagery with take-home relaxation CDs for listening to for 3 days before and 7 days after surgery . In both groups ePTFE tubes were inserted during surgery and removed at 7 days after surgery and analysed for hydroxyproline as a measure of collagen deposition and wound healing . Change in perceived stress from before surgery to 7-day follow-up was assessed using question naires . Intervention group patients showed a reduction in perceived stress compared with the control group , controlling for age . Patients in the intervention group had higher hydroxyproline deposition in the wound than did control group patients ( difference in means 0.35 , 95 % CI 0.66 - 0.03 ; t(43)=2.23 , p=0.03 ) . Changes in perceived stress were not associated with hydroxyproline deposition . A brief relaxation intervention prior to surgery can reduce stress and improve the wound healing response in surgical patients . The intervention may have particular clinical application for those at risk of poor healing following surgery Following traumatic or surgical injury to the skin , wounds do not heal by tissue regeneration but rather by scar formation . Though healing is definitely a welcomed event , the result ant scar , very often , is not aesthetically pleasing , and not infrequently , may be pathologic causing serious deformities and contractures . Management of problematic scars continues to be a frustrating endeavor with less than optimal results . Prophylactic methods of wound management to minimize serious scarring are being developed . In a previously published study , we have demonstrated improved healing of split thickness skin graft donor sites following treatment with Moist Exposed Burn Ointment ( MEBO , Julphar Gulf Pharmaceutical Industries , Ras Al-Kh aim ah , UAE ) . At present , we are reporting the results of a comparative clinical prospect i ve study evaluating scar quality following primary healing of elective surgical and traumatic facial wounds with prophylactic MEBO application , topical antibiotic ointment application , and no topical therapy at all . Scars were evaluated according to the Visual Analogue Scale for scar assessment . Statistical analysis of scar assessment scores demonstrated marked prevention of unfavorable scars with improved cosmetic results following MEBO prophylactic therapy OBJECTIVES There has been growing awareness that alleviation of wound pain and associated symptoms after obstructive sleep apnea ( OSA ) surgeries may improve the quality of care . We performed a hospital-based study to compare the effectiveness and safety of two different regimens in the treatment of postoperative pain . STUDY DESIGN A prospect i ve , r and omized , and parallel-group study . METHODS Ninety OSA patients were enrolled for surgical treatments in this study . Forty-five patients ( group 1 ) were r and omized to receive intravenous ketorolac and another 45 patients ( group 2 ) were given the conventional regimen of oral mefenamic acid and intramuscular meperidine after  OSA surgeries for 3 days at hospital . Postoperative discomfort was measured by a self- assessment question naire on the 1st and 3rd days after surgery . Any adverse effect of pain treatment was carefully monitored . Patients ' satisfaction with postoperative pain treatment was evaluated 1 month postoperatively . RESULTS On the 1st postoperative day , group 1 patients had a significantly lower mean score in six out of eight pain-related symptoms than group 2 patients had ( P<.05 ) . At the 3rd postoperative day , significant differences remained for two symptoms . Group 1 patients were generally more satisfied with their pain treatment than were group 2 patients ( P=.01 ) . Increased risk of postoperative bleeding for group 1 was not observed in this study . CONCLUSIONS A short-term administration of intravenous ketorolac is noninferior to the conventional regimen and represents a safe and effective treatment for wound pain , particularly in the 1st day , after OSA surgeries in selected patients During two separate periods a total of 654 patients were included in a clinical study relating preoperative bacterial colonization to occurrence of postoperative wound infection in plastic surgery . During the second period one half of the patients were r and omized to receive prophylactic azithromycin . Bacteriological sample s were collected from the nasal vestibulum during both periods , and additionally from the surgical field during the second period . All patients had preoperative  chlorhexidine bathing .  The bacteriological findings were categorized as either normal flora or potentially pathogenic bacteria , and as either having no growth . Surgical wounds were divided into four contamination classes . Postoperative follow-up was 30 days , and assessment of wound infection was based on a grade d scale . We did not find any statistically significant relation between preoperative bacterial colonization and postoperative wound infection , regardless of place of sample collection , method of bacterial classification , class of contamination or use of prophylactic azithromycin BACKGROUND We identified factors that influence patient perceptions of their skin cancer surgery through a prospect i ve study of patients referred to a single surgeon during 18 months . METHOD Patients having surgery result ing in a wound sutured and dressed  were surveyed 6 to 9 months later . Monitoring for complaints continued for 3 years . RESULTS In all , 74 % of patients returned the survey ( 576 of 778 ) . A total of 250 ( 43 % ) rated their scar excellent , 177 ( 31 % ) very good , 72 ( 12.5 % ) good , 40 fair ( 6.9 % ) , and 14 ( 2.4 % ) poor or very poor . Age , sex , diagnosis , or closure method did not result in a variation in scar perception . In all , 27.3 % of scars ( 21/77 ) on the trunk were rated neutral or negative compared with 6.9 % ( 33/476 ) of scars elsewhere ( P < .001 ) and only 5 % ( 15/305 ) of head and neck scars ( P < .001 ) . Complications did not change scar or overall evaluation ratings . In all , 393 patients ( 68 % ) rated the overall service excellent , 145 ( 25 % ) very good , 22 ( 4 % ) good , and 3 ( 0.5 % ) fair . No patient rated the service poor or very poor . Patients rating the service lower were most dissatisfied with scar appearance , time waiting before surgery , pain from the local anesthetic , nursing care , follow-up care , cost , and written material . In all , 99 % of patients who rated their scar very good or excellent rated the overall service optimally , compared with only 85 % of patients who rated their scar as good or worse . LIMITATIONS A single experienced surgeon in a southern Australia locale might not reflect the perceptions in other clinicians and locations . CONCLUSION Complications and patient complaints do not identify patient dissatisfaction from cutaneous surgery . The patients ' perception of their scars markedly influences their overall service perception . Patients experienced more dissatisfaction with repairs on the trunk BACKGROUND Wound infection after clean surgery is an expensive and often underestimated cause of patient morbidity , and the benefits of using prophylactic antibiotics have not been proven . Warming patients during colorectal surgery has been shown to reduce infection rates . We aim ed to assess whether warming patients before short duration , clean surgery would have the same effect . METHODS 421 patients having clean ( breast , varicose vein , or hernia ) surgery were r and omly assigned to either a non-warmed ( st and ard ) group or one of two warmed groups ( local and systemic ) . We applied warming for at least 30 min before surgery . Patients were followed up and masked outcome assessment s made at 2 and 6 weeks . FINDINGS Analysis was done on an intention-to-treat basis . We identified 19 wound infections in 139 non-warmed patients ( 14 % ) but only 13 in 277 who received warming ( 5 % ; p=0.001 ) . Wound scores were also significantly lower ( p=0.007 ) in warmed patients . There was no significant difference in the development of haematomas or seromas after surgery but the non-warmed group were prescribed significantly more postoperative antibiotics ( p=0.002 ) . INTERPRETATION Warming patients before clean surgery seems to aid the prevention of postoperative wound infection . If applied according to the manufacturers guidelines these therapies have no known side-effects and might , with the support of further studies , provide an alternative to prophylactic antibiotics in this type of surgery Purpose The purpose of this study was to evaluate the use of negative pressure wound therapy ( NPWT ) to improve  wound healing after total hip arthroplasty ( THA ) and its influence on the development of postoperative seromas in the wound area . Material sThe study is a prospect i ve r and omised evaluation of NPWT in patients with large surgical wounds after THA , r and omising patients to either a st and ard dressing ( group A ) or a NPWT ( group B ) over the wound area . The wound area was examined with ultrasound to measure the postoperative seromas in both groups on the fifth and tenth postoperative days . Results There were 19 patients r and omised in this study . Ten days after surgery , group A ( ten patients , 70.5 ± 11.01 years of age ) developed seromas with an average size of 5.08 ml and group B ( nine patients , 66.22 ± 17.83 years of age ) 1.97 ml . The difference was significant ( p = 0.021 ) . Conclusion NPWT has been used on many different types of traumatic and non traumatic wounds . This prospect i ve , r and omised study has demonstrated decreased development of postoperative seromas in the wound and improved wound healing BACKGROUND Mild perioperative hypothermia , which is common during major surgery , may promote surgical-wound infection by triggering thermoregulatory vasoconstriction , which decreases subcutaneous oxygen tension . Reduced levels of oxygen in tissue impair oxidative killing by neutrophils and decrease the strength of the healing wound by reducing the deposition of collagen . Hypothermia also directly impairs immune function . We tested the hypothesis that hypothermia both increases susceptibility to surgical-wound infection and lengthens hospitalization . METHODS Two hundred patients undergoing colorectal surgery were r and omly assigned to routine intraoperative thermal care ( the hypothermia group ) or additional warming ( the normothermia group ) . The patient 's anesthetic care was st and ardized , and they were all given cefam and ole and metronidazole . In a double-blind protocol , their wounds were evaluated daily until discharge from the hospital and in the clinic after two weeks ; wounds containing culture-positive pus were considered infected . The patients ' surgeons remained unaware of the patients ' group assignments . RESULTS The mean ( + /- SD ) final intraoperative core temperature was 34.7 + /- 0.6 degrees C in the hypothermia group and 36.6 + /- 0.5 degrees C in the normothermia group ( P < 0.001 ) Surgical-wound infections were found in 18 of 96 patients assigned to hypothermia ( 19 percent ) but in only 6 of 104 patients assigned to normothermia ( 6 percent , P = 0.009 ) . The sutures were removed one day later in the patients assigned to hypothermia than in those assigned to normothermia ( P = 0.002 ) , and the duration of hospitalization was prolonged by 2.6 days ( approximately 20 percent ) in hypothermia group ( P = 0.01 ) . CONCLUSIONS Hypothermia itself may delay healing and predispose patients to wound infections . Maintaining normothermia intraoperatively is likely to decrease the incidence of infectious complications in patients undergoing colorectal resection and to shorten their hospitalizations OBJECTIVES To show that the use of absorbable sutures in pediatric traumatic lacerations affords good long-term cosmesis and no increase in complications ( infection , dehiscence rates , and need for surgical scar revision ) when compared with wounds sutured with nonabsorbable sutures . METHODS This was a r and omized clinical trial conducted in a pediatric emergency department . Patients 1 - 18 years of age who presented to the emergency department with lacerations < 12 hours old were recruited between January 1999 and December 2001 . Exclusion criteria were the following : wounds that could be approximated by tissue adhesives , animal/human bites , gross contamination , puncture/crush wounds , wounds crossing joints , lacerations of tendon/nerve/cartilage , collagen vascular disease , immunodeficiency , diabetes mellitus , bleeding disorder , and scalp lacerations . Patients were r and omized into one of two groups : those receiving absorbable plain gut sutures ( group A ) and those receiving nonabsorbable nylon sutures ( group NA ) . Board-eligible/certified pediatric emergency physicians or clinical fellows performed laceration repair in a st and ardized approach . All wounds were reevaluated within ten days by a single research nurse who assessed the wounds using a previously vali date d wound evaluation score ( WES ) composed of six items ( presence of step-off , contour irregularities , margin separation , edge inversion , extensive distortion , and overall cosmetic appearance ) . A score of 6/6 was considered optimal . The study nurse also noted the presence of infection and dehiscence . The patients were then seen by a single blinded plastic surgeon at four or five months who evaluated the wound using a previously vali date d visual analog scale of cosmesis ( VAS ) . In addition , the surgeon repeated the WES and assessed the need for surgical scar revision . RESULTS A total of 147 patients were eligible , and 52 patients declined to participate . Of the 95 patients enrolled , 50 were r and omized to group A and 45 to group NA . The two groups had similar ages , gender distributions , rates of use of sedation or steri-strips , wound lengths and widths , mechanisms of injury , and wound locations . At the short-term follow-up , no difference was found in the proportion of optimal WES scores between group A ( 63 % of patients ) and group NA ( 49 % of patients ) ( relative risk = 0.73 ; 95 % confidence interval [ 95 % CI ] = 0.45 to 1.17 ) . No difference was found in the rates of infection and dehiscence between the two groups . Sixty-three of the 95 patients presented for long-term follow-up . The groups remained similar with respect to patient and wound characteristics as well as wound location . The average VAS score at four months was 79 ( 95 % CI = 73 to 85 ) for group A and 66 ( 95 % CI = 55 to 76 ) for group NA . In addition , no differences were found in the proportion of optimal WES between group A ( 36 % of patients ) and group NA ( 28 % of patients ) at four months ( relative risk = 0.88 ; 95 % CI = 0.62 to 1.26 ) . Surgical scar revision was recommended for only three patients , of whom two were in group A. No patients chose to have their scars revised . No differences were found between group A and group NA for the rates of dehiscence ( 2 % vs. 11 % ; p = 0.07 ) and infection ( 0 vs. 2 ; p = 0.3 ) . CONCLUSIONS The use of plain catgut absorbable sutures in the repair of traumatic lacerations in children appears to be an acceptable alternative to nonabsorbable sutures because the long-term cosmetic outcome seems to be at least as good . In this study , plain gut suture material seemed to provide slightly better cosmesis . In addition , no difference was found in the rate of dehiscence or infection between the groups Abstract Background A decision of the Federal Joint Committee Germany in 2008 stated that negative pressure wound therapy is not accepted as a st and ard therapy for full reimbursement by the health insurance companies in Germany . This decision is based on the final report of the Institute for Quality and Efficiency in Health Care in 2006 , which demonstrated through systematic review s and meta- analysis of previous study projects , that an insufficient state of evidence regarding the use of negative pressure wound therapy for the treatment of acute and chronic wounds exists . Further studies were therefore indicated . Methods / design The study is design ed as a multinational , multicenter , prospect i ve r and omized controlled , adaptive design , clinical superiority trial , with blinded photographic analysis of the primary endpoint . Efficacy and effectiveness of negative pressure wound therapy  for wounds in both medical sectors ( in- and outpatient care ) will be evaluated . The trial compares the treatment outcome of the application of a technical medical device which is based on the principle of negative pressure wound therapy ( intervention group ) and st and ard conventional wound therapy ( control group ) in the treatment of subcutaneous abdominal wounds after surgery . The aim of the SAWHI-VAC ® study is to compare the clinical , safety and economic results of both treatment arms . Discussion The study project is design ed and conducted with the aim of providing solid evidence regarding the efficacy of negative pressure wound therapy .  Study results will be provided until the end of 2014 to contribute to the final decision of the Federal Joint Committee Germany regarding the general admission of negative pressure wound therapy as a st and ard of performance within both medical sectors . Trial registration Clinical Trials.gov NCT01528033 German Clinical Trials Register Objective To evaluate the nutritional status and behavior of the surgical wound following cheiloplasty .  Setting Hospital for Rehabilitation of Craniofacial Anomalies , University of São Paulo ( HRAC/USP ) , Bauru , São Paulo , Brazil . Participants Forty-five nursing children aged 3 to 13 months old , either bottle-fed or spoon-fed , su bmi tted to cheiloplasty during the study period . Results The results did not demonstrate significant differences between the study groups regarding gender , age , nutritional status , and condition of the surgical wound . Upon completion of the study , the infants of both groups were eutrophic , presenting increase in growth and development , with no hematoma , significant edema , sutural dehiscence , bleeding , or infection at the operated area . Conclusions Both kinds of nursing , spoon- and bottle-feeding , had the same influence on nutritional status and wound condition in both study groups . We suggest that bottle-feeding should be tried in patients in the postoperative period of cheiloplasty , because this method was used after surgery without causing any damage to the lip surgical wound OBJECTIVE The aim of this study was to determine the effects of Hypericum perforatum on  cesarean wound healing and hypertrophic scar .  DESIGN This was a r and omized , double-blind clinical trial study . SETTING The study was conducted in Samen-Ol-Aemmeh ( Pbuh ) Hospital in Mashhad , Iran . SUBJECTS The subjects included 144 women with surgical childbirth who had eligible criteria . INTERVENTION The participants were r and omly assigned to three groups . The treatment and placebo groups applied H. perforatum or placebo ointment 3 times a day for 16 days based on consecutive coded ointments . The control group remained without any intervention postoperatively . ASSESSMENT Wound healing was assessed on the 10th day postcesarean using the REEDA scale ( REEDA st and s for redness , edema , ecchymosis , discharge , and approximation ) , which had criteria including redness , edema , ecchymosis , discharge , and approximation . On the 40th day , the degree of scarring was assessed using the Vancouver scar scale including pigmentation , height , pliability , and vascularity . The subjects were also asked some questions about pain by using the Visual Analogue Scale and pruritus of scar . RESULTS The mean age of all the study subjects was 23.50 + /- 4.03 and mean parity was 1.23 + /- 0.48 . There were significant differences in wound healing on the 10th day ( p < 0.005 ) and scar formation on the 40th day postpartum ( p < 0.0001 ) between treatment group with placebo and control groups . However , the placebo group had no differences in wound healing ( p = 0.93 ) and scar formation ( p = 0.11 ) with the control group . In addition , significantly lower pain and pruritus were reported by the treatment group compared with the placebo and control groups on the 40th day postpartum . CONCLUSIONS Topical application of H. perforatum is safe and can facilitate cesarean wound healing and minimize formation of scar and its pain and pruritus In a five year period ( 1984 - 1988 ) in the department of obstetrics and gynaecology of the University of Ilorin Teaching Hospital , Ilorin , 304 laparotomy patients whose skin incisions were closed with the traditional method of interrupted non-absorbable sutures or with absorbable subcuticular sutures were analysed . Out of these 304 patients , 164 had non-absorbable skin sutures  while 140 had  absorbable subcuticular sutures . The results of the two methods of skin closure were compared immediately on discharge , at 6 weeks and at 6 months after the operation . The appearance of the wounds and scar were better in the absorbable subcuticular group than in the non-absorbable interrupted group . The differences between the two groups were statistically significant in the cross-scar formation , Keloid/hypertrophic scar formation , period of hospitalisation and the acceptance rate . Subcuticular skin closure had the advantages of short stay in hospital , non stitch removal , better scar formation and being more acceptable to patients . There was no significant difference in the age between the two groups . All the patients were Africans A prospect i ve study of postoperative wounds was carried out in West Dorset to determine the incidence of infection , describe the time distribution of presentation before and after discharge from hospital and identify possible contributory factors . There were 702 consecutive patients admitted to the study ( 600 in- patients and 102 day cases ) . Fifty one became infected ( 47 in- patients and 4 day cases ) , corresponding to an overall infection rate of 7.3 % . Over 50 % of infections presented during the first week after operation , and almost 90 % were diagnosed within 2 weeks of surgery Twenty-eight ( 55 % ) wounds that became infected presented after hospital discharge . Of 23 specific aetiological variables studied , four ( age , preoperative stay , shaving and the surgeon ) were shown to have a statistically significant association with the development of wound infection . A strong association between the individual surgeon and the development of a wound infection was demonstrated and this supports the need for routine surgical audit OBJECTIVE To determine whether or not the routine use of postoperative dressings prevents surgical site infection and wound dehiscence . MATERIAL AND METHODS Patients with clean or clean-contaminated ( e.g. hernia , orchidectomy cystolithotomy , ureterolithotomy , appendectomy ) sutured surgical wounds were r and omised into two groups : those who did not receive postoperative dressings ( the study group ) and those who did ( the control group ) . Variables like adequate haemostasis , sterile techniques , obliteration of all wound cavities , and approximation of divided structures were not controlled for . Wounds were assessed after 6 and 24 hours , and on the third and fifth postoperative days for clinical signs of infection and dehiscence . RESULTS A total of 123 patients with 124 clean surgical wounds were recruited into the study . The mean age and ratio of men and women in each group were comparable . There was no significant difference in the rate of wound complications between the two groups : 4.76 % for the study group and 4.92 % for control . CONCLUSION Based on these preliminary data , surgical wounds left open do not have an increased incidence of surgical site infection and wound dehiscence , compared with similar types of wounds dressed postoperatively . In a large teaching hospital , the extrapolated cost savings of dressing material s alone can be significant . Larger studies are needed to confirm these results . CONFLICT OF INTEREST None AIM An association has been proposed between perioperative administration of 80 % oxygen and a lower incidence of wound infection after colorectal surgery . The present study was conducted to assess this hypothesis . METHODS Thirty-eight patients ( ASA classification 1 and 2 ) undergoing elective colorectal cancer surgery were allocated at r and om to 2 groups . Group 1 consisted of 19 patients who received an admixture of 80 % oxygen and 20 % nitrogen during anesthesia through an orotracheal tube and during the 2 first hours in the recovery room through a tight facemask with reservoir . Group 2 consisted of 19 patients who received an admixture of 70 % nitrous oxide and 30 % oxygen during anesthesia , followed by administration of 30 % oxygen delivered by a blender through a tight facemask with reservoir in the same manner than group 1 , during the first 2 hours in the recovery room . Wound infection was evaluated daily during hospital stay and after 7 days , 2 weeks , and 1 month . RESULTS The incidence of wound infection was 12.5 % in group 1 and 17.6 % in group 2 ( p=0.53 ) . CONCLUSIONS The results of this study showed no reduction in the incidence of wound infection following elective colorectal surgery in patients receiving 80 % oxygen during the perioperative period BACKGROUND AND OBJECTIVES Laser treatment in the early phases of wound healing may reduce scar formation . However , little is known on when in the early wound healing phases laser exposure most optimally should be provided and at which fluence levels . This study investigates the clinical effect of non-ablative-fractional-laser ( NAFL ) performed at three early time points at a range of fluence levels versus untreated control scars . MATERIAL S AND METHODS A r and omized , controlled , intra-individual trial with erbium-glass 1,540 nm NAFL versus no laser treatment on sixteen subjects receiving 10 st and ardized full-thickness punch-biopsy wounds . A single NAFL-exposure was applied to test-wounds 1 day before , immediately after , or 2 weeks after wounding . Three fluence levels provided deep and superficial energy depositions ( range 30 - 70 mJ/microbeam ) . Primary outcome comprised the total-score of the observer part of Patient-Observer-Scar- Assessment -Scale ( POSAS ) , performed by blinded on-site assessment at 3 months follow-up . Secondary outcomes were clinical evaluation on visual-analogue-scale ( VAS ) , reflectance measurements , and histology .  RESULTS NAFL-treatment applied 1 day before , immediately after or 2 weeks after wounding had the potential to offer subtle but detectable improvement in clinical scar appearance compared to untreated controls . Thus , NAFL-exposure 1 day before wounding ( POSAS-total : median of 15 vs. control-median of 16 , P = 0.03 , VAS : median 4.1 vs. control-median 5.5 , P = 0.03 , medium-fluence ) , as well as immediately- , and 2 weeks after wounding ( POSAS-total : P ≤ 0.05 , low-fluence ) induced improvement compared to untreated controls . No significant differences in dyschromia were detected between NAFL-treated and control scars . Histology showed subtle changes towards more mature interwoven bundles of collagen in NAFL-treated scars as compared to controls . CONCLUSIONS This study indicates that a single NAFL-treatment at low to medium fluence performed 1 day prior , or in the early phases of wound healing , may have the potential to optimize scar formation in full thickness wounds . Lasers Surg . Med . 50:28 - 36 , 2018 . © 2017 Wiley Periodicals ,
Conclusions This systemic review shows that preoperative interventions can be beneficial in improving wound healing and scar formation .
In selected cases , wound healing was found to benefit from a higher preoperative body temperature , topical vitamin E application , and low patient stress levels .
Background Poor wound healing and scar formation  remain critical problems in daily surgical practice .
Generally , most attention is paid to intra- and postoperative interventions to improve wound healing after surgery , while preoperative interventions remain unsatisfactorily explored .
Objectives In this systematic review , the available literature on the beneficial effects of preoperative interventions on wound healing and scar formation have been summarized and compared .