Chronic wound

A chronic wound is a wound that does not progress through the normal stages of wound healing—haemostasis, inflammation, proliferation, and remodeling—in a predictable and timely manner. Typically, wounds that do not heal within three months are classified as chronic.[1] Chronic wounds may remain in the inflammatory phase due to factors like infection or bacterial burden, ischaemia, presence of necrotic tissue, improper moisture balance of wound site, or underlying diseases such as diabetes mellitus.[2][3][4]

In acute wounds, a regulated balance of pro-inflammatory cytokines (signalling molecules) and proteases (enzymes) prevent the degradation of the extracellular matrix (ECM) and collagen to ensure proper wound healing.[5][6]

In chronic wounds, there is excessive levels of inflammatory cytokines and proteases, leading to excessive degradation of the ECM and collagen. This disrupts tissue repair and impedes recovery, keeping the wound in a non-healing state.

Chronic wounds may take years to heal or, in some cases, may never heal, causing significant physical and emotional stress for patients and placing a financial burden on healthcare systems.[7] Acute and chronic wounds are part of a spectrum, with chronic wounds requiring prolonged and complex care compared to acute wounds.[8]

  1. ^ Mustoe T (March 17–18, 2005). "Dermal ulcer healing: Advances in understanding" (PDF). Tissue repair and ulcer/wound healing: molecular mechanisms, therapeutic targets and future directions. Paris, France: EUROCONFERENCES. Archived from the original (PDF) on October 27, 2005.
  2. ^ Snyder RJ (2005). "Treatment of nonhealing ulcers with allografts". Clinics in Dermatology. 23 (4): 388–95. doi:10.1016/j.clindermatol.2004.07.020. PMID 16023934.
  3. ^ Taylor JE, Laity PR, Hicks J, Wong SS, Norris K, Khunkamchoo P, et al. (October 2005). "Extent of iron pick-up in deforoxamine-coupled polyurethane materials for therapy of chronic wounds". Biomaterials. 26 (30): 6024–33. doi:10.1016/j.biomaterials.2005.03.015. PMID 15885771.
  4. ^ Gist S, Tio-Matos I, Falzgraf S, Cameron S, Beebe M (June 2009). "Wound care in the geriatric client". Clinical Interventions in Aging. 4: 269–87. doi:10.2147/CIA.S4726. PMC 2697592. PMID 19554098.
  5. ^ Edwards JV, Howley P, Cohen IK (October 2004). "In vitro inhibition of human neutrophil elastase by oleic acid albumin formulations from derivatized cotton wound dressings". International Journal of Pharmaceutics. 284 (1–2): 1–12. doi:10.1016/j.ijpharm.2004.06.003. PMID 15454291. Archived from the original on June 7, 2019.
  6. ^ Schönfelder U, Abel M, Wiegand C, Klemm D, Elsner P, Hipler UC (November 2005). "Influence of selected wound dressings on PMN elastase in chronic wound fluid and their antioxidative potential in vitro". Biomaterials. 26 (33): 6664–73. doi:10.1016/j.biomaterials.2005.04.030. PMID 15978664.
  7. ^ Augustin M, Maier K (2003). "Psychosomatic aspects of chronic wounds". Dermatology and Psychosomatics/Dermatologie und Psychosomatik. 4 (1): 5–13. doi:10.1159/000070529. S2CID 72066898.
  8. ^ Moreo K (2005). "Understanding and overcoming the challenges of effective case management for patients with chronic wounds". The Case Manager. 16 (2): 62–3, 67. doi:10.1016/j.casemgr.2005.01.014. PMID 15818347.
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