Frykberg RG, Banks J, et al.
Advances in wound care. Date of publication 2015 Sep 1;volume 4(9):560-582.
1. Adv Wound Care (New Rochelle). 2015 Sep 1;4(9):560-582.
Challenges in the Treatment of Chronic Wounds.
Frykberg RG(1), Banks J(1).
Author information:
(1)Phoenix VA Health Care System , Phoenix, Arizona.
Significance: Chronic wounds include, but are not limited, to diabetic foot
ulcers, venous leg ulcers, and pressure ulcers. They are a challenge to wound
care professionals and consume a great deal of healthcare resources around the
globe. This review discusses the pathophysiology of complex chronic wounds and
the means and modalities currently available to achieve healing in such patients.
Recent Advances: Although often difficult to treat, an understanding of the
underlying pathophysiology and specific attention toward managing these
perturbations can often lead to successful healing. Critical Issues: Overcoming
the factors that contribute to delayed healing are key components of a
comprehensive approach to wound care and present the primary challenges to the
treatment of chronic wounds. When wounds fail to achieve sufficient healing after
4 weeks of standard care, reassessment of underlying pathology and consideration
of the need for advanced therapeutic agents should be undertaken. However,
selection of an appropriate therapy is often not evidence based. Future
Directions: Basic tenets of care need to be routinely followed, and a systematic
evaluation of patients and their wounds will also facilitate appropriate care.
Underlying pathologies, which result in the failure of these wounds to heal,
differ among various types of chronic wounds. A better understanding of the
differences between various types of chronic wounds at the molecular and cellular
levels should improve our treatment approaches, leading to better healing rates,
and facilitate the development of new more effective therapies. More evidence for
the efficacy of current and future advanced wound therapies is required for their
appropriate use.
DOI: 10.1089/wound.2015.0635
PMCID: PMC4528992
PMID: 26339534
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