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VIII.
Chronic (non-healing) Wounds |
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Overview
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Chronic wounds differ
substantially from an acute wound. The
wound no longer follows the normal healing
processes The term “non-healing wound” is
often used to describe the chronic wound.
Characteristics are presented. However,
the exact distinction between acute and
chronic is still somewhat arbitrary and
often based on the cause of the wound and
physical status of the patient.
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The time period most
commonly used to define a chronic wound is usually
3 months of lack of healing. The most common
chronic wounds are pressure ulcers, diabetic ulcers
and venous stasis ulcers. The 3 categories account
for 70% of chronic wounds. (Table 1) However, any
acute wound, which fails to follow the normal healing
process can become a chronic wound. It is important
that criteria for determining when an acute wound
becomes a chronic wound be met before calling a wound
“chronic”. For example, a pressure ulcer
characteristically heals slower than an acute surgical
wound but a pressure ulcer can progressively heal by
the normal healing process. It only becomes a chronic
wound if there is failure of the normal healing
process. Successful treatment of the chronic wound
depends on a thorough understanding of the
pathophysiologic mechanisms underlying the failure of
the normal wound healing process.
These wounds cause a major disability due to the
chronicity and frequent recurrence and therefore
negatively impact quality of life in addition to
producing an enormous health care cost. (3 billion/yr
in the US).
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