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[The non-healing wound].

F Pfeffer1, E von Dobschuetz, H Riediger

  • 1Abteilung für Allgemein- und Viszeralchirurgie, Chirurgische Universitätsklinik Freiburg i. Br. pfeffer@ch11.ukl.uni-freiburg.de

MMW Fortschritte Der Medizin
|November 30, 2004
PubMed
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This study outlines a comprehensive approach to managing chronic wounds, including pressure ulcers and diabetic foot ulcers. The integrated wound care model successfully heals 80% of chronic wounds, emphasizing causal treatment and coordinated care.

Area of Science:

  • Wound Healing
  • Chronic Wound Management
  • Regenerative Medicine

Background:

  • Common chronic wounds include pressure ulcers, diabetic ulcers, arterial occlusive disease, and venous ulcers.
  • Effective management requires addressing both local wound factors (infection, necrosis) and systemic patient factors (compliance, comorbidities).

Purpose of the Study:

  • To present a coordinated, multidisciplinary approach for the causal treatment and management of chronic wounds.
  • To evaluate the efficacy of an integrated wound care concept in achieving successful wound healing outcomes.

Main Methods:

  • Comprehensive diagnostic work-up to identify causal factors.
  • Therapeutic measures including pressure relief, revascularization, compression, repeated debridement, and wet dressings.

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  • Infection management with local antiseptics and supportive therapies like protease inhibitors, growth factors, or tissue engineering.
  • Coordination of surgical, diabetological, and dermatological disciplines within a wound care center, with liaison to primary care and home care providers.
  • Main Results:

    • The integrated wound care concept successfully heals approximately 80% of chronic wounds.
    • The mean healing duration for chronic wounds was 4.8 months, with an overall treatment duration of 18.8 months.
    • Regular documentation of wound healing progress is mandatory for treatment success.

    Conclusions:

    • A multidisciplinary, coordinated approach is crucial for effective chronic wound management.
    • Causal treatment combined with appropriate local and systemic therapies significantly improves healing rates.
    • This comprehensive wound healing concept demonstrates high success rates in treating complex chronic wounds.