Whenever the integrity of the skin is impaired, via trauma or surgical incision, wounds und wound healing are the natural consequences. Thus, every physician should be interested in the biological processes involved in wound healing. The physician does not usually interfere with these natural processes, knowing that the body heals itself (natura sanat). It is not until the natural wound healing process is disturbed, that we realize how little we know about this area. Our limited knowledge is not even available to most physicians. Advances in the areas of cell-and molecular biology have also resulted in substantial progress in the field of wound healing. Today, we know that the process of tissue repair occurs in three phases and is controlled by specific cells. These cells release potent mediators which in turn regulate the function of other cells surrounding the area. "Certain rules apply to the healing of wounds and injured tissue. You must follow nature for nature will never follow you," this sentence writen by Paracelsus in his book "Chirurgia magna" is still valid today. Current reseach in wound healing is exploring these rules and integrating them into new therapeutical concepts. The purpose of this book is to make current knowledge on basic healing processes, research in this area and on wound management available to most physicians. Due to the importance of wound healing and the successful combination of basic science and clinical aspects, I would like this book to be widely accepted.

This book is the fruit of lectures given during the symposium "Proteolytic Enzymes and Wound Healing" at the Joint Meet ing of the Wound Healing Society and the European Tissue Repair Society held in Amsterdam, August 22-25, 1993. Look ing back, we can conclude with satisfaction that the meeting was a great success, with regard to both the number of partici pants and the scientific level. Enormous progress is being made in the field of wound heal ing and tissue repair. It was therefore of prime importance that one fundamental aspect in the healing of chronic wound- the proteolytic debridement of tissue necrosis - be given thorough attention during the above-mentioned symposium. Renowned authors dealt with the various aspects of proteoly tic enzymes and wound healing, so that a unique overview was given. The lectures were written up and arranged into the various chapters of this book, which should provide the reader with a practical guide in understanding and treating necrotic wounds. Wiete Westerhof, M. D., Ph. D. President of the Organizing Committee of the Joint Meeting of the Wound Healing Society and the European Tissue Repair Society Contents Pathobiology of Necrosis P. K. Das and W. Westerhof.. ................................... ."