|Year : 2014 | Volume
| Issue : 1 | Page : 1-2
Wound healing: The presiding deity of surgery
Manu Kothari1, Atul Goel2
1 Department of Anatomy, K. E. M. Hospital and Seth G.S. Medical College, Parel, Mumbai, Maharashtra, India
2 Department of Neurosurgery, K. E. M. Hospital and Seth G.S. Medical College, Parel, Mumbai, Maharashtra, India
|Date of Web Publication||24-Jun-2014|
Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai - 400 012, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kothari M, Goel A. Wound healing: The presiding deity of surgery. J Craniovert Jun Spine 2014;5:1-2
There is little that can be called original since a sharp flint opened an abscess and some horsehair threaded through the first thorn needle sewed upon wound. Yet it all goes on, bit by bit, and the wheel of progress turns a little in man's lifetime.
Sir Harold Gilles and D. Ralph Millard in the Principles and Art of Plastic Surgery
The primitive man saw an abscess burst on its own and fully resolve itself, as also a wound-small or big, or even very big-heal on its own, and the art of surgery was born. The surgeon wields a knife that heals by wounding, be it an abscess laid open, or the abdominal or chest cavity opened up to be closed.
Surgery, however sophisticated remains an art with precious little achieved from the flint-and-horsehair times. The doyens of plastic surgery, Gilles and Maynard, have been humble enough to own up the basic nonscience ness of the art of surgery.
The science of surgery solely rests on the willingness of the body to heal after a wound from within, or more often, from without, by a process supremely efficient and inscrutably mysterious. From a shaving-scratch to a polytrauma of head-on collision, the healing of wound gets orchestered in utter silence, in the absence of any medical wisdom or supervision and so very often despite medical interference. The body strives to restore the tissues to status quo ante wholeness, by precise sequence of healing events. The term heal is traceable to hale, hal, meaning sound, healthy, and beautiful. To heal is to restore health.
Over 200 years of research on wound healing has allowed medical science to know only the spelling of the phrase without deciphering its essence. At a Lister symposium on wound healing at Glasgow, 1970, the Chairman summed up the entire meet on four counts:
- Nature has attained the zenith of perfection in wound healing.
- We know nothing of wound healing.
- We cannot accelerate it.
- So often, we decelerate it.
The 1970 generalization holds true to the dot now, and would for another 1000 years at the least. Today medical science, cellular science is facing a grave crisis of basic binary blindness. We don't know what a cell is. The science of cytology was centered on the nucleus as the boss, but facts have turned out to be otherwise. The so-called cytoplasm is the boss, and the cytoplasm being nebulous is beyond-science, beyond microscopes, beyond research.
A cell is
What it is
For it does
What it does
And it does
For it is
What it is.
The other aspect of medical blindness is the collagen fiber that comprising 1054 amino acids is the most complex molecule in the animal body that has its own inscrutability and its own inner clock. Collagen irrevocably ages the animal body by strictly comparable inner clock and there is no reversing the clock.
Modern medicine should climb down to earth level to accept its lofty ignorance on cell, fiber and wound healing. Wound healing is mysterious, inscrutable, almost divine, and merits being the presiding deity of the magnificent art of surgery.
The healing of the neuraxis - brain or spinal cord - needs some elaboration. The neurons, being nonmitotic perennial cells, once lost are lost forever. Neurons that die do not get replaced by neurons but by glial cells and the fibroblasts and collagen fibers off the blood vessels. Neurons, like sensory - receptors and muscle cells are nonmitotic reparatively as tumorogenically. The cells that fill a neuraxial gap are fibroblasts, neuroglial cells and the accompanying vasculature. This neoplasm-new tissue - essentially contracts to comprise a cicatrix of minimal dimensions. Whatsoever reparatively holds true for neuraxis holds true for sense organs and muscles.
We may end here with a prayer that a surgeon ought to make, after propitiating its deity named wound healing.
Dear Saint Luke, friend and advisor to Saint Paul, guide my hand and eye for the sake of my patient. Steady my nerves and my scalpel; watch the microbes and the nurses; make muscles, veins, arteries and nerves behave according to the book; keep an eye on the anesthetist. Save us all from lapses of memory, fraying of tempers, confusion of bottles and instruments; miscounting of swabs, and blunders of diagnosis. If it is "kill or cure," please cure; if it is "kill or maim," please maim, but save my patient…And as there is no more time for praying, I say Amen.
The Linacre Quarterly, August 1954, "A Prayer for Surgeons"