const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = 'LAYOUT_WIDE';
pres.author = 'Bailey & Love';
pres.title = 'Wound Classification and Wound Healing';

// ─── COLOUR PALETTE ───────────────────────────────────────────
const C = {
  navyDark:  "0D1B2A",
  navy:      "1B2A4A",
  teal:      "1A7A6E",
  tealLight: "25A99A",
  gold:      "E8A020",
  white:     "FFFFFF",
  offWhite:  "F0F4F8",
  grey:      "7A8A9A",
  lightGrey: "D0D8E4",
  red:       "C0392B",
  green:     "1E8449",
};

// ─── HELPER: SECTION DIVIDER SLIDE ───────────────────────────
function addDividerSlide(title, subtitle) {
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    color: C.white, fontFace: "Calibri", align: "center", valign: "middle",
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    color: C.grey, fontFace: "Calibri", align: "right",
  });
  return s;
}

// ─── HELPER: CONTENT SLIDE ────────────────────────────────────
function addContentSlide(title, bullets, opts = {}) {
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    color: C.grey, fontFace: "Calibri", align: "right",
  });
  return s;
}

// ─── HELPER: TWO-COLUMN SLIDE ────────────────────────────────
function addTwoColSlide(title, leftBullets, rightBullets, leftTitle, rightTitle) {
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    color: C.grey, fontFace: "Calibri", align: "right",
  });
  return s;
}

// ─── HELPER: PHASE CARD SLIDE ────────────────────────────────
function addPhaseSlide(phaseNum, phaseName, color, timeframe, cells) {
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    color: C.white, fontFace: "Calibri", valign: "middle", margin: 0,
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  const startY = [1.2, 1.2, 4.0, 4.0];
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      shadow: { type: "outer", blur: 4, offset: 2, angle: 45, color: "AAAAAA", opacity: 0.25 },
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      align: "center", valign: "middle", margin: 0,
      fill: { color: color },
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    const bArr = cell.points.map((p, j) => ({
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    color: C.grey, fontFace: "Calibri", align: "right",
  });
  return s;
}

// ─── HELPER: TABLE SLIDE ─────────────────────────────────────
function addTableSlide(title, rows) {
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  s.addText(title, {
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    color: C.white, fontFace: "Calibri", valign: "middle", margin: 0,
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    color: C.grey, fontFace: "Calibri", align: "right",
  });
  return s;
}

// ══════════════════════════════════════════════════════════════
//  SLIDE 1 — TITLE
// ══════════════════════════════════════════════════════════════
{
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  // Bottom decorative strip
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  s.addShape(pres.ShapeType.rect, { x: 0, y: 6.7, w: 13.3, h: 0.12, fill: { color: C.gold } });
  // Top accent
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  s.addShape(pres.ShapeType.rect, { x: 11.0, y: 0.12, w: 0.08, h: 6.5, fill: { color: C.tealLight } });

  s.addText("WOUND CLASSIFICATION", {
    x: 0.7, y: 1.2, w: 9.6, h: 1.0, fontSize: 38, bold: true,
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    color: C.white, fontFace: "Calibri", charSpacing: 3,
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  s.addText("Based on Bailey & Love's Short Practice of Surgery", {
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  s.addText("27th Edition", {
    x: 0.7, y: 6.85, w: 4, h: 0.5, fontSize: 14, bold: true,
    color: C.white, fontFace: "Calibri",
  });
}

// ══════════════════════════════════════════════════════════════
//  SLIDE 2 — OVERVIEW / TABLE OF CONTENTS
// ══════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.navy } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 0.1, fill: { color: C.tealLight } });
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  });
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  const sections = [
    { num: "01", label: "Normal Wound Healing in Skin", sub: "Phases: Haemostasis · Inflammation · Proliferation · Remodelling" },
    { num: "02", label: "Abnormal Wound Healing", sub: "Hypertrophic scars · Keloid scars · Factors affecting healing" },
    { num: "03", label: "Types of Wound Healing", sub: "Primary · Secondary · Tertiary (Delayed Primary)" },
    { num: "04", label: "Classification of Wounds", sub: "CDC Surgical Wound Classification · Aetiology · Depth · Complexity" },
    { num: "05", label: "Wound Management", sub: "Assessment · Treatment principles" },
  ];

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    s.addShape(pres.ShapeType.rect, { x: 0.5, y, w: 1.0, h: 0.9, fill: { color: C.teal } });
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}

// ══════════════════════════════════════════════════════════════
//  SECTION DIVIDER — WOUND HEALING
// ══════════════════════════════════════════════════════════════
addDividerSlide("WOUND HEALING", "Normal Physiology of Wound Repair");

// ══════════════════════════════════════════════════════════════
//  SLIDE 3 — PHASES OVERVIEW (Timeline graphic)
// ══════════════════════════════════════════════════════════════
{
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  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.12, h: 7.5, fill: { color: C.teal } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 1.0, fill: { color: C.navy } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 1.0, w: 13.3, h: 0.06, fill: { color: C.gold } });
  s.addText("PHASES OF NORMAL WOUND HEALING", {
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    color: C.white, fontFace: "Calibri", valign: "middle", margin: 0,
  });

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    x: 0.4, y: 1.15, w: 12.5, h: 0.7, fontSize: 17, color: C.navy, fontFace: "Calibri", italic: true,
  });

  // Phase boxes
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    { label: "Haemostasis", time: "Minutes–Hours", color: C.red, x: 0.4, w: 2.7 },
    { label: "Inflammation", time: "Days 1–3", color: "E86A10", x: 3.3, w: 2.7 },
    { label: "Proliferation", time: "Day 3 – 4 Weeks", color: C.teal, x: 6.2, w: 3.5 },
    { label: "Remodelling", time: "Months–2 Years", color: C.navy, x: 9.9, w: 3.0 },
  ];
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    s.addShape(pres.ShapeType.rect, { x: p.x, y: 2.0, w: p.w, h: 1.3, fill: { color: p.color } });
    s.addText(p.label, { x: p.x, y: 2.0, w: p.w, h: 0.75, fontSize: 18, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "bottom" });
    s.addText(p.time, { x: p.x, y: 2.75, w: p.w, h: 0.55, fontSize: 13, color: C.white, fontFace: "Calibri", align: "center", valign: "middle", italic: true });
    // Down arrow
    s.addShape(pres.ShapeType.rect, { x: p.x + p.w / 2 - 0.05, y: 3.3, w: 0.1, h: 0.35, fill: { color: p.color } });
  });

  // Key points for each phase
  const keyPoints = [
    { x: 0.4, color: C.red, pts: ["Vasoconstriction", "Platelet plug forms", "Coagulation cascade → Fibrin clot"] },
    { x: 3.3, color: "E86A10", pts: ["Neutrophils (days 1–2)", "Macrophages (days 2–3)", "Rubor, tumor, calor, dolor"] },
    { x: 6.2, color: C.teal, pts: ["Fibroblast activity (day 3+)", "Collagen synthesis", "Angiogenesis + epithelialisation", "Granulation tissue formation"] },
    { x: 9.9, color: C.navy, pts: ["Collagen remodelling (type III→I)", "Tensile strength increases", "Myofibroblast contraction", "Scar matures: pale, flat"] },
  ];
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  s.addText("Bailey & Love's Short Practice of Surgery", {
    x: 7, y: 7.1, w: 6, h: 0.35, fontSize: 11, italic: true, color: C.grey, fontFace: "Calibri", align: "right",
  });
}

// ══════════════════════════════════════════════════════════════
//  SLIDE 4 — HAEMOSTASIS (detailed)
// ══════════════════════════════════════════════════════════════
addPhaseSlide(1, "Haemostasis", C.red, "Minutes – Hours", [
  {
    heading: "Vascular Response",
    points: ["Disruption of vascular endothelium → vasoconstriction", "Exposure of subendothelial extracellular matrix", "Limits initial blood loss"],
  },
  {
    heading: "Platelet Activation & Aggregation",
    points: ["Platelets adhere, activate, aggregate → platelet plug", "Alpha granules release growth factors: TGF-β, PDGF, FGF, EGF, VEGF", "Growth factors drive ECM deposition, chemotaxis, angiogenesis"],
  },
  {
    heading: "Coagulation Cascade",
    points: ["Tissue factor → initiates cascade", "Thrombin formed → converts fibrinogen → fibrin", "Fibrin stabilises platelet plug, forms scaffold for cells"],
  },
  {
    heading: "Key Outcome",
    points: ["Stable fibrin clot formed", "Scaffold ready for inflammatory cell infiltration", "Transition to inflammatory phase begins"],
  },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 5 — INFLAMMATION (detailed)
// ══════════════════════════════════════════════════════════════
addPhaseSlide(2, "Inflammation", "E86A10", "Days 1–3", [
  {
    heading: "Early Phase (Days 1–2)",
    points: ["Platelet activation → influx of PMNs, especially neutrophils", "Neutrophils: minimise bacterial contamination", "Vasoactive amines (histamine, serotonin) increase vascular permeability"],
  },
  {
    heading: "Late Phase (Days 2–3)",
    points: ["Monocytes appear → differentiate into macrophages", "Macrophages: phagocytosis + proteolytic debridement", "Primary producers of cytokines & growth factors"],
  },
  {
    heading: "Cardinal Signs of Inflammation",
    points: ["Rubor (redness)", "Tumor (swelling)", "Calor (heat)", "Dolor (pain)"],
  },
  {
    heading: "Transition to Proliferation",
    points: ["Macrophages release PDGF, TGF-β promoting fibroblast proliferation", "Angiogenesis stimulated", "Phase overlaps with proliferation from ~day 3"],
  },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 6 — PROLIFERATION (detailed)
// ══════════════════════════════════════════════════════════════
addPhaseSlide(3, "Proliferation", C.teal, "Day 3 – 2–4 Weeks", [
  {
    heading: "Fibroblast Activity",
    points: ["Start ~day 3; lasts 2–4 weeks", "Produce ground substance: glycosaminoglycans + proteoglycans", "Collagen synthesis — initially type III, later type I"],
  },
  {
    heading: "Granulation Tissue",
    points: ["Pink, granular appearance (early)", "Consists of new capillaries, fibroblasts, and ECM", "Fills wound defect from base upwards"],
  },
  {
    heading: "Re-epithelialisation",
    points: ["Epithelial cells migrate from wound edges & skin appendages", "Keratinocyte proliferation covers wound surface", "Dependent on moist wound environment"],
  },
  {
    heading: "Angiogenesis",
    points: ["VEGF & FGF drive new vessel formation", "Essential for oxygen/nutrient delivery", "New vessels visible as red, granular tissue"],
  },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 7 — REMODELLING (detailed)
// ══════════════════════════════════════════════════════════════
addPhaseSlide(4, "Remodelling", C.navy, "Months – Up to 2 Years", [
  {
    heading: "Collagen Remodelling",
    points: ["Type III collagen replaced by type I (stronger)", "Net collagen content decreases but organisation improves", "Collagen crosslinking increases tensile strength"],
  },
  {
    heading: "Tensile Strength",
    points: ["50% of original strength at 6 weeks", "80% by 3 months", "Never exceeds ~80% of original skin strength"],
  },
  {
    heading: "Wound Contraction",
    points: ["Myofibroblasts responsible for wound contraction", "Actin-containing cells contract wound edges", "Important mechanism in healing by secondary intention"],
  },
  {
    heading: "Scar Maturation",
    points: ["Initially red and raised", "Progressively becomes pale, flat, soft", "Vascularity decreases over months"],
  },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 8 — ABNORMAL WOUND HEALING
// ══════════════════════════════════════════════════════════════
addTwoColSlide(
  "ABNORMAL WOUND HEALING",
  [
    "Confined within original wound boundary",
    "Eventually spontaneously regress",
    "Areas of increased tension",
    "Wounds crossing tension lines",
    "Deep dermal burns",
    "Wounds healing by secondary intention (> 3 weeks)",
    "Treatment: silicone, intralesional steroids, compression",
  ],
  [
    "Extend BEYOND original wound borders",
    "Do NOT spontaneously regress",
    "Can be locally destructive / debilitating",
    "More common in darker skin types",
    "Collagen arranged in disorganised pattern",
    "Common sites: face, earlobes, deltoid, presternal",
    "Treatment: excision + adjuvant radiotherapy; more resistant",
  ],
  "HYPERTROPHIC SCARS",
  "KELOID SCARS"
);

// ══════════════════════════════════════════════════════════════
//  SLIDE 9 — FACTORS AFFECTING WOUND HEALING
// ══════════════════════════════════════════════════════════════
addTwoColSlide(
  "FACTORS AFFECTING WOUND HEALING  (Bailey & Love Summary Box 3.1)",
  [
    "Skin tension",
    "Hypoxia and ischaemia",
    "Vascular insufficiency",
    "Lymphoedema",
    "Contamination",
    "Infection",
    "Presence of foreign bodies",
    "Radiotherapy",
  ],
  [
    "Advancing age",
    "Obesity",
    "Malnutrition",
    "Smoking",
    "Diabetes mellitus",
    "Connective tissue diseases",
    "Immunocompromised states (e.g. AIDS)",
    "Medications: steroids, immunosuppressants, chemotherapy",
  ],
  "LOCAL FACTORS",
  "SYSTEMIC FACTORS"
);

// ══════════════════════════════════════════════════════════════
//  SECTION DIVIDER — TYPES OF WOUND HEALING
// ══════════════════════════════════════════════════════════════
addDividerSlide("TYPES OF WOUND HEALING", "Intentions of Healing — Summary Box 3.2");

// ══════════════════════════════════════════════════════════════
//  SLIDE 10 — TYPES OF HEALING
// ══════════════════════════════════════════════════════════════
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// ══════════════════════════════════════════════════════════════
//  SECTION DIVIDER — WOUND CLASSIFICATION
// ══════════════════════════════════════════════════════════════
addDividerSlide("WOUND CLASSIFICATION", "Synopsis of Classification Systems — Summary Box 3.3");

// ══════════════════════════════════════════════════════════════
//  SLIDE 11 — CDC SURGICAL WOUND CLASSIFICATION (Table)
// ══════════════════════════════════════════════════════════════
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// ══════════════════════════════════════════════════════════════
//  SLIDE 12 — WOUND CLASSIFICATION: SYNOPSIS
// ══════════════════════════════════════════════════════════════
addContentSlide("WOUND CLASSIFICATION — SYNOPSIS  (Summary Box 3.3)", [
  "AETIOLOGY:",
  { text: "Clean surgical, shearing/degloving, crush, blast, burn (thermal/electrical/chemical/radiation), cold injury, avulsion/traction, low/high energy, bite", sub: true },
  "DEPTH:",
  { text: "Epidermal, Dermal (superficial or deep), Full thickness", sub: true },
  "CONTAMINATION:",
  { text: "Clean, Clean–contaminated, Contaminated, Dirty | With or without implant", sub: true },
  "COMPLEXITY:",
  { text: "Simple, Complex, Significant soft-tissue loss, Open fracture/joint, Visceral involvement", sub: true },
  "COMPLICATED:",
  { text: "Infection, Necrosis, Haematoma, Gas gangrene, Compartment syndrome", sub: true },
  "CHRONIC:",
  { text: "Vascular ulcers (venous or arterial), Pressure ulcers, Diabetic ulcers", sub: true },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 13 — NNIS RISK SCORE
// ══════════════════════════════════════════════════════════════
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// ══════════════════════════════════════════════════════════════
//  SECTION DIVIDER — WOUND MANAGEMENT
// ══════════════════════════════════════════════════════════════
addDividerSlide("WOUND MANAGEMENT", "Assessment & Treatment Principles");

// ══════════════════════════════════════════════════════════════
//  SLIDE 14 — WOUND MANAGEMENT
// ══════════════════════════════════════════════════════════════
addContentSlide("WOUND MANAGEMENT — KEY PRINCIPLES", [
  "Use ATLS principles: identify life-threatening → limb-threatening conditions first",
  "Assess: site, size, geometry, nature of wound; signs of contamination, infection, swelling, pulsatile bleeding",
  "Look for: skin loss, degloving, exposed structures, underlying fractures / dislocations",
  "Correlate clinical examination with mechanism of injury (e.g. high-pressure injection injuries can track proximally)",
  "Ensure adequate analgesia before palpation; test motor and sensory function before local anaesthesia",
  "Imaging: to exclude foreign bodies, fractures, dislocations as appropriate",
  "Thorough wound irrigation for better visualisation and decontamination",
  "Multidisciplinary approach for complex wounds (e.g. open lower limb fractures: orthopaedic + plastic surgery)",
  "Wound management guided by timing, mechanism of injury, and patient-specific factors affecting healing",
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 15 — SUMMARY / TAKE-HOME POINTS
// ══════════════════════════════════════════════════════════════
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// ══════════════════════════════════════════════════════════════
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// ══════════════════════════════════════════════════════════════
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// ─── HELPER: PHASE CARD SLIDE ─────────────────────────────────
function addPhaseSlide(phaseNum, phaseName, color, timeframe, cells) {
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}

// ══════════════════════════════════════════════════════════════
//  SLIDE 1 — TITLE
// ══════════════════════════════════════════════════════════════
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}

// ══════════════════════════════════════════════════════════════
//  SLIDE 2 — OVERVIEW / TABLE OF CONTENTS
// ══════════════════════════════════════════════════════════════
{
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    { num: "01", label: "Normal Wound Healing in Skin", sub: "Phases: Haemostasis · Inflammation · Proliferation · Remodelling", color: C.teal },
    { num: "02", label: "Abnormal Wound Healing", sub: "Hypertrophic scars · Keloid scars · Factors affecting healing", color: "E86A10" },
    { num: "03", label: "Types of Wound Healing", sub: "Primary · Secondary · Tertiary (Delayed Primary)", color: C.green },
    { num: "04", label: "Classification of Wounds", sub: "CDC Surgical Wound Classification · Aetiology · Depth · Complexity", color: C.navy },
    { num: "05", label: "Wound Management", sub: "Assessment · Treatment principles", color: C.red },
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// ══════════════════════════════════════════════════════════════
//  SECTION DIVIDER — WOUND HEALING
// ══════════════════════════════════════════════════════════════
addDividerSlide("WOUND HEALING", "Normal Physiology of Wound Repair");

// ══════════════════════════════════════════════════════════════
//  SLIDE 4 — PHASES OVERVIEW (Timeline graphic)
// ══════════════════════════════════════════════════════════════
{
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    { label: "Inflammation", time: "Days 1–3", color: "E86A10", x: 3.3, w: 2.7 },
    { label: "Proliferation", time: "Day 3 – 4 Wks", color: C.teal, x: 6.2, w: 3.5 },
    { label: "Remodelling", time: "Months–2 Yrs", color: C.navy, x: 9.9, w: 3.0 },
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    { x: 3.3, color: "E86A10", pts: ["Neutrophils (days 1–2)", "Macrophages (days 2–3)", "Rubor, tumor, calor, dolor"] },
    { x: 6.2, color: C.teal, pts: ["Fibroblast activity (day 3+)", "Collagen synthesis", "Angiogenesis + epithelialisation", "Granulation tissue formation"] },
    { x: 9.9, color: C.navy, pts: ["Collagen remodelling III→I", "Tensile strength increases", "Myofibroblast contraction", "Scar matures: pale, flat"] },
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}

// ══════════════════════════════════════════════════════════════
//  SLIDE 5 — HAEMOSTASIS (detailed)
// ══════════════════════════════════════════════════════════════
addPhaseSlide(1, "Haemostasis", C.red, "Minutes – Hours", [
  {
    heading: "Vascular Response",
    points: ["Disruption of vascular endothelium → vasoconstriction", "Exposure of subendothelial extracellular matrix", "Limits initial blood loss"],
  },
  {
    heading: "Platelet Activation & Aggregation",
    points: ["Platelets adhere, activate, aggregate → platelet plug", "Alpha granules release: TGF-β, PDGF, FGF, EGF, VEGF", "Growth factors drive ECM deposition, chemotaxis, angiogenesis"],
  },
  {
    heading: "Coagulation Cascade",
    points: ["Tissue factor → initiates cascade", "Thrombin formed → fibrinogen → fibrin", "Fibrin stabilises plug; forms scaffold for cells"],
  },
  {
    heading: "Key Outcome",
    points: ["Stable fibrin clot formed", "Scaffold ready for inflammatory cell infiltration", "Transition to inflammatory phase begins"],
  },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 6 — INFLAMMATION (detailed)
// ══════════════════════════════════════════════════════════════
addPhaseSlide(2, "Inflammation", "E86A10", "Days 1–3", [
  {
    heading: "Early Phase (Days 1–2)",
    points: ["Platelet activation → influx of PMNs, especially neutrophils", "Neutrophils: minimise bacterial contamination", "Histamine, serotonin increase vascular permeability"],
  },
  {
    heading: "Late Phase (Days 2–3)",
    points: ["Monocytes appear → differentiate into macrophages", "Macrophages: phagocytosis + proteolytic debridement", "Primary producers of cytokines & growth factors"],
  },
  {
    heading: "Cardinal Signs of Inflammation",
    points: ["Rubor (redness)", "Tumor (swelling)", "Calor (heat)", "Dolor (pain)"],
  },
  {
    heading: "Transition to Proliferation",
    points: ["Macrophages release PDGF, TGF-β → fibroblast proliferation", "Angiogenesis stimulated", "Phase overlaps proliferation from ~day 3"],
  },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 7 — PROLIFERATION (detailed)
// ══════════════════════════════════════════════════════════════
addPhaseSlide(3, "Proliferation", C.teal, "Day 3 – 2–4 Weeks", [
  {
    heading: "Fibroblast Activity",
    points: ["Starts ~day 3; lasts 2–4 weeks", "Produce ground substance: glycosaminoglycans + proteoglycans", "Collagen synthesis — initially type III, later type I"],
  },
  {
    heading: "Granulation Tissue",
    points: ["Pink, granular appearance (early phase)", "Consists of new capillaries, fibroblasts, and ECM", "Fills wound defect from base upwards"],
  },
  {
    heading: "Re-epithelialisation",
    points: ["Epithelial cells migrate from wound edges & skin appendages", "Keratinocyte proliferation covers wound surface", "Dependent on moist wound environment"],
  },
  {
    heading: "Angiogenesis",
    points: ["VEGF & FGF drive new vessel formation", "Essential for oxygen/nutrient delivery", "New vessels visible as red, granular tissue"],
  },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 8 — REMODELLING (detailed)
// ══════════════════════════════════════════════════════════════
addPhaseSlide(4, "Remodelling", C.navy, "Months – Up to 2 Years", [
  {
    heading: "Collagen Remodelling",
    points: ["Type III collagen replaced by type I (stronger)", "Net collagen content decreases but organisation improves", "Collagen crosslinking increases tensile strength"],
  },
  {
    heading: "Tensile Strength",
    points: ["50% of original strength at 6 weeks", "80% by 3 months", "Never exceeds ~80% of original skin strength"],
  },
  {
    heading: "Wound Contraction",
    points: ["Myofibroblasts responsible for contraction", "Actin-containing cells contract wound edges", "Important in healing by secondary intention"],
  },
  {
    heading: "Scar Maturation",
    points: ["Initially red and raised", "Progressively becomes pale, flat, soft", "Vascularity decreases over months"],
  },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 9 — ABNORMAL WOUND HEALING
// ══════════════════════════════════════════════════════════════
addTwoColSlide(
  "ABNORMAL WOUND HEALING",
  [
    "Confined within original wound boundary",
    "Eventually spontaneously regress",
    "Areas of increased tension",
    "Wounds crossing tension lines",
    "Deep dermal burns",
    "Wounds healing by secondary intention (> 3 weeks)",
    "Collagen in parallel pattern",
    "Treatment: silicone, intralesional steroids, compression",
  ],
  [
    "Extend BEYOND original wound borders",
    "Do NOT spontaneously regress",
    "Can be locally destructive / debilitating",
    "More common in darker skin types",
    "Collagen in disorganised pattern",
    "Common sites: face, earlobes, deltoid, presternal",
    "May arise months after relatively minor trauma",
    "Treatment: excision + adjuvant radiotherapy; more resistant",
  ],
  "HYPERTROPHIC SCARS",
  "KELOID SCARS"
);

// ══════════════════════════════════════════════════════════════
//  SLIDE 10 — FACTORS AFFECTING WOUND HEALING
// ══════════════════════════════════════════════════════════════
addTwoColSlide(
  "FACTORS AFFECTING WOUND HEALING  (Summary Box 3.1)",
  [
    "Skin tension",
    "Hypoxia and ischaemia",
    "Vascular insufficiency",
    "Lymphoedema",
    "Contamination",
    "Infection",
    "Presence of foreign bodies",
    "Radiotherapy",
  ],
  [
    "Advancing age",
    "Obesity",
    "Malnutrition",
    "Smoking",
    "Diabetes mellitus",
    "Connective tissue diseases",
    "Immunocompromised states (e.g. AIDS)",
    "Medications: steroids, immunosuppressants, chemotherapy",
  ],
  "LOCAL FACTORS",
  "SYSTEMIC FACTORS"
);

// ══════════════════════════════════════════════════════════════
//  SECTION DIVIDER — TYPES OF WOUND HEALING
// ══════════════════════════════════════════════════════════════
addDividerSlide("TYPES OF WOUND HEALING", "Intentions of Healing — Summary Box 3.2");

// ══════════════════════════════════════════════════════════════
//  SLIDE 11 — TYPES OF HEALING (3-card)
// ══════════════════════════════════════════════════════════════
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      pts: ["Wound left OPEN", "Heals by granulation, contraction, re-epithelialisation", "Increased inflammation and proliferation", "Results in a poorer scar"],
    },
    {
      title: "3rd INTENTION\n(Tertiary / Delayed Primary)",
      color: C.navy,
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      pts: ["Wound initially left open (contaminated/untidy)", "Edges apposed surgically after debridement", "Wound must be clean first", "Better outcome than secondary intention"],
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// ══════════════════════════════════════════════════════════════
//  SECTION DIVIDER — WOUND CLASSIFICATION
// ══════════════════════════════════════════════════════════════
addDividerSlide("WOUND CLASSIFICATION", "Synopsis of Classification Systems — Summary Box 3.3");

// ══════════════════════════════════════════════════════════════
//  SLIDE 12 — CDC SURGICAL WOUND CLASSIFICATION
// ══════════════════════════════════════════════════════════════
{
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    { cls: "Class II\nCLEAN-CONTAMINATED", color: "1A7A2E", desc: "Respiratory, alimentary, genital or urinary tracts entered under controlled conditions | No unusual contamination | No evidence of infection or major break in technique" },
    { cls: "Class III\nCONTAMINATED", color: "E86A10", desc: "Open, fresh, accidental wounds | Major breaks in sterile technique | Gross spillage from GI tract | Incisions with acute, non-purulent inflammation" },
    { cls: "Class IV\nDIRTY", color: C.red, desc: "Old traumatic wounds with retained devitalised tissue | Existing clinical infection | Perforated viscera | Organisms present in surgical field BEFORE operation" },
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// ══════════════════════════════════════════════════════════════
//  SLIDE 13 — WOUND CLASSIFICATION SYNOPSIS
// ══════════════════════════════════════════════════════════════
addContentSlide("WOUND CLASSIFICATION — SYNOPSIS  (Summary Box 3.3)", [
  "AETIOLOGY:",
  { text: "Clean surgical, shearing/degloving, crush, blast, burn (thermal/electrical/chemical/radiation), cold injury, avulsion/traction, low/high energy, bite", sub: true },
  "DEPTH:",
  { text: "Epidermal, Dermal (superficial or deep), Full thickness", sub: true },
  "CONTAMINATION:",
  { text: "Clean, Clean–contaminated, Contaminated, Dirty | With or without implant", sub: true },
  "COMPLEXITY:",
  { text: "Simple, Complex, Significant soft-tissue loss, Open fracture/joint, Visceral involvement", sub: true },
  "COMPLICATED:",
  { text: "Infection, Necrosis, Haematoma, Gas gangrene, Compartment syndrome", sub: true },
  "CHRONIC:",
  { text: "Vascular ulcers (venous or arterial), Pressure ulcers, Diabetic ulcers", sub: true },
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 14 — NNIS RISK INDEX SCORE
// ══════════════════════════════════════════════════════════════
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    { num: "+1", label: "ASA Score ≥ 3", detail: "American Society of Anesthesiologists physical status score 3 or higher indicating significant systemic disease", color: "E86A10" },
    { num: "+1", label: "Prolonged Operative Time", detail: "Operative time longer than expected for similar procedures (> 75th percentile)", color: C.teal },
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// ══════════════════════════════════════════════════════════════
//  SECTION DIVIDER — WOUND MANAGEMENT
// ══════════════════════════════════════════════════════════════
addDividerSlide("WOUND MANAGEMENT", "Assessment & Treatment Principles");

// ══════════════════════════════════════════════════════════════
//  SLIDE 15 — WOUND MANAGEMENT
// ══════════════════════════════════════════════════════════════
addContentSlide("WOUND MANAGEMENT — KEY PRINCIPLES", [
  "Use ATLS principles: identify life-threatening → limb-threatening conditions first",
  "Assess: site, size, geometry, nature of wound; signs of contamination, infection, swelling, pulsatile bleeding",
  "Look for: skin loss, degloving, exposed structures, underlying fractures / dislocations",
  "Correlate clinical examination with mechanism of injury (e.g. high-pressure injection injuries can track proximally)",
  "Ensure adequate analgesia before palpation; test motor and sensory function before local anaesthesia",
  "Imaging: to exclude foreign bodies, fractures, dislocations as appropriate",
  "Thorough wound irrigation for better visualisation and decontamination",
  "Multidisciplinary approach for complex wounds (e.g. open lower limb fractures: orthopaedic + plastic surgery)",
  "Management guided by timing, mechanism of injury, and patient-specific factors affecting healing",
]);

// ══════════════════════════════════════════════════════════════
//  SLIDE 16 — KEY TAKE-HOME POINTS
// ══════════════════════════════════════════════════════════════
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    "NNIS score (0–3): contaminated wound + ASA ≥3 + prolonged operative time each add 1 point",
    "3 types of healing: Primary (1st), Secondary (2nd — open wound), Tertiary/Delayed Primary (3rd)",
    "Hypertrophic scars stay within wound boundary; keloid scars extend beyond and do not regress",
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// ══════════════════════════════════════════════════════════════
//  WRITE FILE
// ══════════════════════════════════════════════════════════════
pres.writeFile({ fileName: "/home/daytona/workspace/wound-ppt/Wound_Classification_Healing_BaileyLove.pptx" })
  .then(() => console.log("PPT created successfully!"))
  .catch(e => { console.error("ERROR:", e); process.exit(1); });

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Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/wound-ppt/create_ppt.js'