Which of the following surgical techniques lead to improved wound healing?

a. Atraumatic handling of tissue

d. Meticulous hemostasis

There are numerous practical implications for the care of wounds and surgical incisions. Meticulous hemostasis reduces the inflammation of phagocytosis necessary to clear the wound of blood. Atraumatic handling of tissue decreases the load of necrotic or nonviable cells at the wound margin. Deep sutures are best placed only into collagen laden structures that will hold tension, i.e., fascia and dermis. These tissues have a tensile strength to hold sutures under tension. Fat does not contain collagen and will not hold tension. Therefore, fatty tissue should not be sutured as a separate layer. Given that epithelialization of an incision is normally complete within 24–48 hours, there is no reason to protect the incision from water beyond this time period. Allowing the patient to wash or shower one or two days after surgery actually serves useful purpose in debriding the wound.