More evidence for the efficacy of current and future advanced wound therapies is required for their appropriate use.Ĭ hronic lower extremity ulcers are those that do not progress through the healing process in a timely manner and have become a major challenge to healthcare systems worldwide. 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. Underlying pathologies, which result in the failure of these wounds to heal, differ among various types of chronic wounds. However, selection of an appropriate therapy is often not evidence based.įuture Directions: Basic tenets of care need to be routinely followed, and a systematic evaluation of patients and their wounds will also facilitate appropriate care. 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. 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.Ĭritical 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. This review discusses the pathophysiology of complex chronic wounds and the means and modalities currently available to achieve healing in such patients. They are a challenge to wound care professionals and consume a great deal of healthcare resources around the globe. Significance: Chronic wounds include, but are not limited, to diabetic foot ulcers, venous leg ulcers, and pressure ulcers.
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