Acute wound is any surgical wound that heals by primary intention, delayed primary intention or secondary intention. It is expected to progress through the phases of normal healing, resulting in the closure of the wound.  They can occur anywhere on the body and vary from superficial scratches to deep wounds damaging blood vessels, nerves and muscles. Major causes includes Surgical, Traumatic or burn wounds. Management includes wound cleansing and dressing. A wound will require different management and treatment at various stages of healing. The goal of wound cleansing is to remove visible debris and devitalized tissue, dressing residue, excessive or dry crusting exudate and to reduce contamination. It should be performed in a way
that minimizes trauma to the wound. Irrigation is the preferred method for cleansing open wounds. Wounds are best cleansed with sterile isotonic saline or water, warmed to body temperature. No dressing is suitable for all wounds; therefore frequent assessment of the wound is required. The appropriate dressing can have a significant effect on the rate and quality of healing. Wound healing progresses most rapidly in an environment that is clean, moist (but not wet), protected from heat loss, trauma and bacterial invasion.
There are a multitude of dressings available to select from. Effective dressing selection requires both accurate wound assessment and current knowledge of available dressings.

Chronic wounds may never heal or may take years to do so. These wounds cause patients severe emotional and physical stress and pain. Therefore, an appropriate treatment is of high importance. It is a wound that fails to progress healing or respond to treatment over the normal expected healing time frame (4 weeks). Wound healing is delayed by the presence of intrinsic
and extrinsic factors including medications, poor nutrition, co-morbidities or inappropriate dressing selection. In order to manage the chronic wounds, proper determination of the etiology for inhibition of wound healing is required to address or control the factors identified for example: presence of
infection, poor nutritional status, appropriate dressing selection, moist wound environment. Dressing selection should be based on the specific wound to promote optimal wound healing. Advanced wound therapies may be utilized including surgical debridement, application of a negative pressure dressing, hyperbaric therapy. It may needs hospital admission and inpatient
care. Specific types of chronic wounds like pressure ulcers require specific management and requires prolonged surgical and nursing care. While during treatment, the patient remains at risk for the development of new pressure ulcers at other sites.   Treatment is based on appropriate staging of the pressure ulcer and includes debridement, topical wound care, control of infection and contamination, regular change of patient positioning and use of appropriate support surfaces.

It is done when the wound is free from infection and contamination and mainly depends upon the degree of tissue loss that may be categorized as superficial wounds – involving the epidermis, partial wound – involves the dermis and epidermis and full thickness wound-involves the epidermis, dermis, subcutaneous tissue and may extend to muscle, bones and tendons and options available for wound reconstruction utilized accordingly that includes skin grafting, flaps, tissue expansion and free tissue transfer using microsurgery.
Skin Grafts: When primary closure is not possible because of a large defect, wound is covered using a skin graft. Small wounds especially on the face and hands covered with a full-thickness skin graft to provide better aesthetic and functional results. It contains epithelium and a full thickness of dermis. The
donor site is closed primarily. Pre-auricular and post-auricular skin and supraclavicular, inguinal, and antecubital skin are all examples of donor sites. Grafts in general are placed over the prepared wound bed and secured with a bolster dressing for 5 to 7 days to ensure contact with the recipient bed. Split-thickness skin grafts are reserved for large wounds and contain epithelium and variable amounts of dermis. The donor site heals spontaneously by epithelialization. Thigh, buttocks, and trunk are all examples of donor sites. Split-thickness grafts are often mashed to expand the surface are to cover larger defects.
Alloy-graft: A cadaveric skin allograft is a useful covering for relatively deep wounds after surgical excision when the wound bed does not appear appropriate for application of an autologous skin graft. The allograft is only a temporary solution and needs additional coverage with split skin graft.
Flaps: are tissue transferred from its bed to an adjacent area while retaining its vascular attachment. Arterial-venous vessels remain in their native bed in a pedicelled flap or are anastomosed by microvascular technique in free flap.
Types of flaps include skin flaps, muscle flaps, musculocutaneous flaps, fascial flaps, fascia-cutaneous flaps, and osteon-cutaneous. Skin flaps may also be classified as local or distant. Local flaps include transposition flaps, interpolation flaps, and advancement flaps (V-Y or rectangular). A rotation flap is a semicircular flap of skin and subcutaneous tissue that is rotated about a pivot point into the defect A transposition flap, such as a rhomboid flap, is elevated and transposed into an adjacent defect. The donor site is closed primarily or skin grafted. An advancement flap is raised and advanced into the defect in a straight line. The degree of advancement depends on the amount of stretching of the skin. A rectangular flap and a V-Y advancement flap are examples of these types of flaps Distant/Rotational flaps with direct transfer are performed by the flap being raised based on a pedicle, which brings blood supply, and being placed to cover the defect. Local vessels grow into the flap, which no longer depends on its pedicle. Examples includes reconstruction of hand defects and the forehead for the reconstruction of nasal defects.
Tissue Expansion: Skin responds to mechanical stress. By expanding local skin surrounding the defect, wounds can be covered with tissue of similar color and texture without compromising the donor area. The tissue expander is placed adjacent to the wound defect to be covered and expanded gradually
until the target width is reached, the device is removed, and the skin is advanced for coverage.
Free Tissue Transfer and Microsurgery: A free flap contains a mass of tissue, with its vascular pedicle, that is transferred surgically from its native body location to a distant defect recipient site where vessel continuity is restored by microvascular anastomosis. This free flap is indicated when a large defect is seen with or without bone, vessel, or nerve exposure in an area where local pedicle flaps are unavailable or too small to cover a large defect