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I have a basic question. I have seen videos of wound treatment, where the doctor induces bleeding around the edge of the wound... to create granulation tissue... then suturing the wound.

My question is... what if an open wound dries up... will it eventually close on its own without inducing bleeding at the edges? or is this a necessary part of reattaching skin together.

I have the same question with regards to muscle, fat... if there's a situation where fat or muscle has torn and needs to be sutured together... does bleeding always need to be induced at the tear to promote reattachment. Or can reattachment happen if the tissues are just sutured together?

EDIT: Here's a video. Warning it is graphic:

https://www.youtube.com/watch?v=sHY9TuqLYRI&t=148s

Watch 2:08-2:27

He talks about roughing up the tissue before suturing. So my question is... what happens if you suture without doing this first... will the skin still eventually close up?

What about an extreme case where the wound has been dry for months... now you suture without doing anything else first... will the skin still fuse together eventually?

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    Can you just include a link of a such video and this can then become a great question.
    – Jan
    Sep 9, 2019 at 8:20
  • I've added a video. Warning the video is graphic. Sep 9, 2019 at 8:52
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    An old wound can close on its own, and most do, but probably with quite some scarring. I believe that treatment of old wounds includes cutting the old tissue to make a fresh wound and suture it. If there is no infection, such a wound can heal just fine with a minimal scarring.
    – Jan
    Sep 10, 2019 at 17:28
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    Hm, I was not clear. By saying an old wound, I meant a wound that is several hours/few days old, not months or so. If you tie the hands together for a long time, they will not fuse. This is also why a wound old enough does not fuse. I'm not sure about exact timing right now.
    – Jan
    Sep 11, 2019 at 6:31
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    Yes, you can say granulation tissue. Wound healing involves several phases (hemostatic, inflammatory, proliferative and maturating), which require the presence of macrophages and other cells to remove the damaged tissue, the arrival of new cells that can build new tissue, etc. woundsource.com/blog/four-stages-wound-healing , ncbi.nlm.nih.gov/books/NBK470443
    – Jan
    Sep 11, 2019 at 12:54

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