Challenges in the Treatment of Chronic Wounds

By R. Frykberg, Jaminelli Banks. Advances in wound care, 2015

2,264 citations recorded by the source corpus.

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.

Subfields: Endocrinology, Diabetes and Metabolism, Rehabilitation, Surgery

View Paper: https://www.semanticscholar.org/paper/3f3a8fa7dd81971772bcc63285f424e1ecce07c8

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Citations in the corpus

Skin Wound Healing Process and New Emerging Technologies for Skin Wound Care and Regeneration (2020, background): “An example of a complex matrix is reported in the study conducted by Singaravelu and colleagues, where a porous keratin–fibrin–gelatin 3D sponge scaffold (KFG-SPG), was designed and the drug mupirocin (D) was incorporated to realize a KFG-SPG-D scaffold for tissue engineering applications [8].”
Wound Healing: A Cellular Perspective. (2019, background): “Diabetes, vascular disease, and aging are the main factors contributing to chronic wounds, causing diabetic foot ulcers, venous leg ulcers, and pressure ulcers, respectively (123).”
Alginate in Wound Dressings (2018, background): “In this phase, there is no evidence of wound and this phase is also referred to as the maturation phase [4,22].”
Drug Delivery Systems and Materials for Wound Healing Applications (2018, neutral): “5 million people need treatment for chronic wounds and it is estimated that over $25 billion is spent annually on management of chronic wounds [2].”
The wound microbiota: microbial mechanisms of impaired wound healing and infection (2024, neutral): “These wounds persist for longer than 3 months and may not ever heal completely 177 .”
The Role of Macrophages in Acute and Chronic Wound Healing and Interventions to Promote Pro-wound Healing Phenotypes (2018, background): “The wound remains in the inflammatory phase, which does not favor tissue regeneration, and therefore, the wound cannot heal (Frykberg and Banks, 2015).”
The humanistic and economic burden of chronic wounds: A systematic review (2018, background): “Chronic wounds, hard-to-heal or difficult-to-heal wounds/ ulcers, are defined as wounds that do not heal properly during an amount of time that normally should be sufficient for healing.(1) There is no preestablished consensus for the duration of chronicity,(2) and the wounds are often managed as a ”