Wounds

A wound occurs when there is a break in the integrity of the skin secondary to an injury, infection or inflammation. Wounds can take a number of forms, including:

Mechanical wounds caused by accidental injury such as a cut, skin tear or graze/abrasion, bite, surgical incision, or self-harm injury
Burns or chemical injuries, which cause direct harm to the different layers within the skin
Chronic wounds, such as ulcers or areas of skin infection that do not heal within 3 months

Normal skin has several important properties, including acting as a barrier to keep out infection and harmful substances and retain moisture. The skin also acts as a sensory organ; allowing us to feel the world around us through touch and temperature. When there is a break in the skin, there is opportunity for harmful microbes to get into the body and cause infection. Therefore, if one suffers a wound, it is important to carry out appropriate first aid. This includes cleaning the wound and applying an appropriate dressing until the skin is healed. In some instances, additional medical treatment may be required. For example, in wounds that are at high risk of infection, prophylactic antibiotics or tetanus immunisation are recommended.

Mr Ioannis Goutos is a London-based plastic surgeon with particular expertise in treating individuals who are suffering from burns and scarring. He has excellent experience and skill in looking after individuals with a wide range of problems and treatment goals. Mr Goutos provides thorough assessment, treatment (including both surgical and non-surgical procedures) and post-treatment care, with each treatment plan tailored to every individual.

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About this condition

The skin has the ability to repair itself through a special healing mechanism which can be broken down into 4 distinct stages:

Stage 1: Haemostatic phase. This begins immediately following any injury to the skin. The body produces small blood clots which prevent excessive blood loss from the wound.
Stage 2: Inflammatory phase. Over the first to fifth day following injury, the immune system works to prevent infection in the wound and prepare the skin for the growth of healing tissue. Immune cells called white blood cells travel to the site of the wound to destroy any bacteria or harmful toxins and remove debris. Individuals may experience some pain, redness and swelling during this phase.
Stage 3: Proliferative phase. This is the stage of regeneration in the skin, where new skin cells, connective tissues and blood vessels are formed to repair the broken skin and restore tissue integrity.
Stage 4: Maturation phase. Once the skin cells have regenerated, there are additional connective tissues, such as collagen, that are remodelled to give the new skin strength and flexibility. This is when scar tissue is remodelled and can take up to 2 years to be fully completed.

There are a number of factors individual to each person that may affect their ability to heal following a wound, including age, medical background (in particular diabetes), medications, smoking status and nutrition.

In some instances, the process of scar formation can cause problems. For example, if there is too much or too little connective tissue laid down, or there is too much tension across the skin as it is healing, the resultant scar can be unsightly, uncomfortable and result in troublesome long term symptoms such as pain or itching. Problem scarring can occur in anyone but is more likely in those who have a family history of adverse scarring, experience complication during healing of the wound or have a connective tissue disorder, such as Ehlers-Danlos syndrome.

In order to promote good scar formation, there are a number of options that can be considered. This includes seeking appropriate medical attention in the event of significant wounds or concerns about wound infection. Keeping the wound clean and dry with the use of appropriate dressings in the initial phases, and then good moisturisation of the skin once the initial healing is complete can help to produce a favourable scar.

In the event of problem scarring, there are a number of treatment options available, including silicone/steroid tapes, needling, laser therapies and surgical options. The most appropriate treatment plan will depend on the individuals initial wound, scarring, symptoms and skin type.

Testimonials

Mr Goutos is delighted to share some of his patient and peer feedback on their experiences of his services.

Louise Steel

2023-08-16

Mr Goutos performed keloidectomy surgery on both my earlobes, and I am so grateful to have been referred to him. From the first consultation, through surgery, and now my 3-month follow-up, I have nothing but good words to say.

Luke Ward

2023-07-10

This man is an extremely intelligent, professional gentleman. He will set realistic expectations from the beginning and will not ‘beat around the bush’ so-to speak. From the initial consultation to post-surgery, it has been a rollercoaster ride. However the high level of expertise & professionalism Mr Goutos maintained has been impeccable. All I can say to any other individual considering treatment with Mr Goutos, is that you are in incredibly safe hands. And on top of this, he has a great sense of humour. I wish nothing but the best for this man, and the best results for his future patients.

Mauricio Lucas

2023-07-06

Outstanding Doctor - Exceptional Expertise I recently had the pleasure of consulting and also going through surgery. Dr. Goutos removed a large class of keloids from my back and chest, and without a doubt, I can confidently say that he is the best doctor I have ever had the privilege of seeing. From the moment I entered his practice, I was immediately struck by his professionalism, knowledge, and exceptional bedside manner. Dr. Goutos possesses an extraordinary level of expertise in his field, and his technical skills are truly remarkable. His ability to diagnose and treat medical conditions is unparalleled, and I have personally witnessed his remarkable success in improving the health and well-being of countless patients. What sets Dr. Goutos apart is his genuine care and concern for his patients. He takes the time to listen attentively, ensuring that he understands every aspect of the medical issue at hand. He communicates clearly and effectively, explaining complex medical concepts in a way that is easy to comprehend, which greatly helps in alleviating any concerns or fears. One aspect that impressed me greatly was Dr. Goutos' commitment to staying updated with the latest advancements in his field. He incorporates cutting-edge techniques and treatments into his practice, ensuring that his patients receive the highest standard of care available. This dedication to continuous learning and improvement is a testament to his unwavering dedication to his profession. Additionally, the support staff at Dr.Goutos' practice deserves recognition for their exceptional service. They are friendly, compassionate, and highly efficient, ensuring that appointments run smoothly and patients feel comfortable throughout the entire process. Overall, I cannot emphasize enough how fortunate I feel to have found Dr.Goutos' exceptional skills, genuine care, and unwavering commitment to his patients make him a truly outstanding specialist. I wholeheartedly recommend him to anyone seeking top-notch medical care.

Kashmala Khan

2023-01-26

Mr. Goutos and his team did an amazing job reversing a scar I had on my forehead. This was a very old scar and had bothered for many years. The laser treatment and fat transfer procedure has changed my life and given me so much confidence. I would definitely recommend him, he is a fantastic and very skilled surgeon. Thank you so much!

Javier

2023-01-14

Mr Goutos and his team removed some lipomas from my arms. The initial consultation right through to the aftercare was professional, sensitive and genuine. Mr Goutos put me at ease right from the start, discussing my history and background and then discussing the various options for the incisions and sutures. The incisions were quick, efficient and professional. I felt completely at ease knowing I was in expert hands. The incisions were extremely neat and have closed and scared really well. I had a number of questions after the operation and one of the sutures became infected. Mr Goutos was quick to make an appointment for me, see me and deal with the infection and offered for me to see him again if the infection didn’t calm down. He was genuinely empathetic to my needs and took time to check each scare, explain things and assure me along the way. He didn’t at any point, make me feel I was asking silly questions or too many. I highly recommend Mr Goutos for his exceptional incisions and suturing as well as his professional conduct, caring approach and after care. The whole experience was smooth and easy and I am very grateful for what he has done for me.

Ieva Lihovida-Yarlett

2022-12-07

We came to see Dr Goutos a few month ago to remove invasive spider nevus on my 9 year old sons nose . After a lovely consultation with Dr Goutos , he suggested to do several laser treatment sessions. After a few sessions we already noticed a massive improvement. On the final laser treatment session the spider nevus was completely gone. Thank you to the Dr Goutos for tackling the problem so rapidly and with great results!

Amy Munson

2022-10-27

We took our 4yr old daughter to Mr Goutos following an accident which resulted in a small burn scar on her cheek. Mr Goutos gave us various options and we went for laser treatment. After 4 appointments the scar has gone! The care that Mr Goutos gave us was exceptional and so good with children. He made us feel very comfortable and confident in his ability. I would recommend him to anyone if they were looking for a doctor in that particular field. Can't thank him enough.