Guided Open Wound Healing: A New Surgical Philosophy

Introduction: Healing the Way Nature Intended

Modern medicine often wants to control healing — stitch it closed, seal it tight, and hope for the best.But the human body doesn’t heal through control; it heals through connection, circulation, and flow.

At Amore Dentistry, we follow a different philosophy — one inspired by Dr. Shahram Ghanaati’s pioneering research in Frankfurt, Germany:✨ Guided Open Wound Healing (GOWH).

Rather than sealing surgical sites under synthetic membranes, this biologic approach allows oxygen and growth factors to guide tissue regeneration naturally.It’s gentle, oxygen-rich, and profoundly effective — and it has completely transformed the way I perform extractions, grafts, and implant surgeries.

Because healing doesn’t need to be forced — it just needs to be supported.

The Conventional Approach: Closing the Door on Healing

For decades, standard dental and medical surgeries relied on a principle called “primary closure.”The goal was to bring soft tissue edges together tightly over the wound, preventing exposure to the oral environment.

While this technique was intended to reduce infection, it often led to complications:

• Trapped bacteria under sutures

• Lack of oxygen exchange

• Tissue tension and necrosis

• Delayed or incomplete healing

In essence, by trying to “protect” the wound, we cut off its natural communication with oxygen — the very thing that drives regeneration.

That realization led Dr. Ghanaati and other biologic surgeons to ask:🌬 What if leaving the wound open — guided by the right biological materials — actually leads to better healing?

The GOWH Concept: Letting Biology Lead

Guided Open Wound Healing (GOWH) is built on one elegant principle:

When the body is given the right biological scaffold and oxygen supply, it knows exactly how to heal.

Rather than covering surgical sites with foreign membranes or synthetic barriers, GOWH relies on the body’s own regenerative tissue — created from your blood — to guide healing from within.

The foundation of this process is Platelet-Rich Fibrin (PRF) — a fibrin matrix derived from your blood that’s rich in growth factors, white blood cells, and stem cells.

When PRF is placed over an extraction site or bone graft, it forms a natural barrier that:

• Protects the wound from contamination

• Encourages angiogenesis (new blood vessel growth)

• Stimulates soft tissue and bone regeneration

• Allows oxygen exchange and drainage

The site remains partially open to air — not exposed, but oxygenated — and that’s the key. Oxygen drives cell metabolism, fibroblast activity, and immune defense.This is why we often say in biologic medicine:💨 “Healing is an aerobic event.”

The Role of PRF: The Body’s Own Healing Matrix

PRF is more than a “bandage.” It’s a living tissue graft.

When we spin your blood in a special centrifuge, it naturally separates into layers. The middle layer — fibrin — contains concentrated platelets, leukocytes, and growth factors like PDGF, VEGF, and TGF-β.

This fibrin clot becomes a biologically active membrane that slowly releases healing signals for up to 10–14 days — acting as a natural scaffold for tissue regrowth.

At Amore Dentistry, we integrate PRF into nearly every surgical case:

• Extractions

• Implant placement

• Bone regeneration

• Cavitation and detox surgery

We also combine it with ozone therapy to oxygenate the wound environment, eliminate pathogens, and enhance blood flow.

The result? Healing that’s faster, cleaner, and infinitely more comfortable for the patient.

Why We Don’t Seal It Shut

This is the part that surprises patients most — and it’s also the most beautiful.

When I explain that we don’t always suture surgical sites closed, they look at me wide-eyed. “Won’t it get infected?” they ask.

Actually, no — it’s quite the opposite.By allowing controlled oxygen exposure and natural drainage, we prevent infection rather than trap it.

Imagine planting a seed. If you bury it under layers of plastic, it won’t sprout. But if you cover it with nutrient-rich soil and let air and moisture circulate, life begins.

That’s what GOWH does — it creates conditions for natural, oxygen-guided healing.

Our job as clinicians isn’t to outsmart nature; it’s to collaborate with it.

The Biologic Benefits of GOWH

The science behind this approach is extensive and compelling:

1. Enhanced OxygenationOpen healing allows the wound to “breathe,” improving oxygen diffusion — essential for fibroblast activity, collagen synthesis, and angiogenesis.

2. Reduced InflammationPRF contains anti-inflammatory cytokines that help regulate immune response, preventing chronic inflammation or fibrosis.

3. Controlled DrainageBy leaving an open pathway, excess fluid can drain naturally — reducing the risk of abscesses or swelling.

4. Natural Tissue ArchitectureRather than forming dense scar tissue, open healing encourages soft, flexible, and vascularized tissue that resembles the body’s original anatomy.

5. No Synthetic Barriers or SuturesThis minimizes foreign-body reactions and reduces the need for removal or secondary surgery.

It’s regenerative, not reparative — meaning the tissue actually restores itself, not just seals over.

A Gentle Revolution in Biologic Surgery

The GOWH philosophy represents a paradigm shift in dentistry — away from “close and cover” toward “guide and grow.”

At Amore Dentistry, our surgical workflow reflects this philosophy at every step:

1. Ozone Therapy: We cleanse and oxygenate the wound, ensuring a sterile and vibrant healing field.

2. PRF Membranes: We place natural fibrin scaffolds derived from your blood.

3. Open Wound Design: We allow controlled exposure for oxygen and lymphatic flow.

4. Nutritional Support: We provide post-surgical care instructions that include hydration, vitamin C, and collagen support.

5. Light Therapy: In some cases, we add photobiomodulation (red light) to activate mitochondrial energy and reduce inflammation.

Together, these steps create a regenerative cascade — where healing isn’t forced, it’s invited.

Patient Experience: “It Just Felt Like My Body Knew What to Do”

One of my patients recently had an infected molar extracted with GOWH. Instead of closing the site completely, we used PRF, a membrane and ozone, allowing it to heal openly.

Her tissues healed beautifully, with soft pink mucosa and healthy bone formation visible on follow-up scans.

That’s the kind of healing that happens when we step back and let nature work.

What This Means for the Future of Dentistry

GOWH is more than a surgical technique — it’s a philosophy that reflects the future of biologic and holistic medicine.

It aligns with everything we believe at Amore Dentistry:

• Trust the body’s innate intelligence.

• Use materials it recognizes (like PRF and oxygen).

• Create an environment that encourages regeneration, not suppression.

I see this philosophy not as “alternative” but as authentic. It’s how the body has always healed — we’re simply rediscovering the wisdom it’s carried all along.

Key Takeaways

GOWH allows wounds to heal naturally with oxygen flow and biologic scaffolding. PRF provides growth factors that guide tissue regeneration. Ozone supports sterilization and circulation without chemicals. Healing is faster, gentler, and more complete — no synthetic barriers needed. It’s a return to biologic truth: the body knows how to heal when we listen.

Conclusion: Guided by Nature, Not by Force

Every time I perform a surgery using the Guided Open Wound Healing approach, I’m reminded that less is truly more.The fewer obstacles we place between biology and its own intelligence, the more beautifully it responds.

In a world where medicine often tries to outsmart nature, this philosophy is refreshingly humble:💫 Guide the process. Don’t dictate it.

At Amore Dentistry, every suture, every membrane, every drop of PRF carries one intention — to honor the body’s innate wisdom and let it lead.

Because the greatest healer in the room has always been the patient’s own biology.

References

1. Ghanaati S, et al. “Guided open wound healing concept for soft tissue regeneration.” J Oral Implantol. 2018. PubMed

2. Ghanaati S, et al. “PRF-based wound healing: from biology to clinical protocols.” Clin Oral Investig. 2021. PubMed

3. Ghanaati S, Choukroun J. “PRF and the concept of open healing.” Implantologie Journal. 2017.

4. Miron RJ, et al. “Use of platelet-rich fibrin in regenerative dentistry: clinical outcomes.” J Periodontol. 2017. PubMed

5. IAOMT Clinical Protocols. “Biologic Surgery and PRF Integration.” International Academy of Oral Medicine & Toxicology, 2020.