What Is a Chronic Wound?

The wound cannot proceed in the three phases of normal healing, but enters a persistent inflammatory state

Chronic wound

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The wound cannot proceed in the three phases of normal healing, but enters a persistent inflammatory state

Chinese name

Chronic wound

Foreign name

Chronic wounds

Affiliation

Illness

Divide

Venous ulcer

English name: Chronic wounds ^[1]

Chronic wounds are generally classified into five types: venous ulcers, arterial ulcers, diabetic ulcers, traumatic ulcers, and pressure ulcers. Others include wounds caused by tumors and connective tissue diseases such as leprosy.

The causes of chronic wounds are complicated, mainly including venous insufficiency, peripheral vascular diseases, systemic diseases, trauma scars and infections. The factors affecting wound healing are also complex and diverse, both systemic and local. Chronic diseases, vascular problems, diabetes, neuropathy, malnutrition, advanced age, and stress, infections, and edema can all hinder wound healing. In addition, the reduction of growth factors in tissues, the imbalance of proteolytic enzymes and their inhibins, and the presence of senescent cells also play a significant role in chronic wounds.

The clinical manifestations of chronic wounds vary from cause to cause, and must be carefully examined to capture the characteristics of their clinical manifestations, plus the necessary tests to investigate the cause. This requires a comprehensive evaluation of the patient, including the following:

1. Causes of wounds;

2. The initial manifestation of the wound: location, size, whether there is exudation and odor, etc .;

3. Whether it is accompanied by pain and the nature and aggravating factors of pain;

4. Previous diagnosis and treatment of wounds and their effects;

5. Systemic diseases and medication history that affect wound healing;

6. History of surgery;

7. History of allergies;

8. Family history.

The evaluation of a wound must also describe its size, depth, wound margin, basal tissue, location, etc. For superficial ulcers, a sterile blunt probe should be used to check whether the probe has penetrated the sinus tract, whether the ulcer has a latent cavity and the ulcer has penetrated into the tendon sheath, bone, and joints. For atypical ulcers or suspected malignant ulcers, a tissue biopsy is required to confirm the diagnosis. If there is an infection, a thorough surgical preparation of the ulcer should be performed after the ulcer base is cut or a purulent sample is taken for culture, colony counting, drug sensitivity testing, etc., and bacteria, mycobacteria, fungal staining, and tissue culture can also be performed. .

The main treatment is etiology treatment. The principle of non-surgical treatment is to control infection and promote healing, mainly to clean wounds, remove necrotic tissue, and strengthen drug replacement. Others, such as VSD technology is suitable for various acute and chronic trauma ulcers, and the negative pressure value is better adjusted at -130 ~ -110mmHg; hyperbaric oxygen therapy can increase blood oxygen concentration, promote capillary regeneration, wound healing; physical therapy, growth Factors (such as fibronectin, fibroblast growth factor, etc.) all play a role in tissue repair.