Surgical management of chronic wounds T

The management of chronic wounds poses a challenge to internists and surgeons alike. Chronic wounds are trapped in a nonadvancing phase of healing and are unable to progress through the sequential stages of tissue repair. The primary roles of surgery in managing these wounds are debridement and wound closure. Surgical debridement releases the chronic wound from its arrested state by removing nonviable tissue, bacteria, and other inhibitory factors, effectively converting it into an acute wound that can undergo healing more effectively. Debridement can be accomplished with a number of techniques, and recent innovations in the wound care industry have added invaluable tools to the wound healing armamentarium. While surgical debridement and closure provide definitive treatment, identifying and treating the underlying cause of a chronic wound is critical to promoting timely healing and preventing wound recurrence.