[The difficult wound]

Difficult wounds of different origin are a challenge for medical and custodial knowledge and capability. They are often characterised by a complex and protracted course of disease and cause considerable costs. Critical wounds particularly include chronic wounds such as venous stasis ulcers, diabetic foot ulcers or pressure ulcers and often lead to physical and psychosocial strain. Large-scale and deep wounds, wounds in traumatised tissue, wound complications and infections as well as wounds in patients with severe accompanying diseases or in patients of old age are often marked by a severe and unpredictable course and are therefore a threat for patients. Knowledge of characteristic symptoms and particularities of the course of disease are essential for early diagnosis and succsessful treatment. Despite many recent advances in wound care the management is often compounded by a lack of clearly defined, comprehensive wound care standards.