A wound is defined as chronic if it has failed to heal after a period of 4 to 12 weeks. Chronic wounds can cause the person affected a good deal of trouble and discomfort. These open wounds are very complex in terms of care – help often needs to be called in from outside so that they can be looked after adequately. In the therapy of chronic wounds, special bandaging material is used in large quantities.
Examples of chronic wounds are varicose ulcers (»ulcus cruris venosum«) and pressure sores (»decubitus«).
The treatment of a chronic wound involves several different disciplines, i.e. at first in collaboration with other specialists such as a vascular surgeon and the family doctor, causes of the chronic failure to heal need to be found and, if possible, treated.
The tasks of the plastic surgeon treating the patient are to assess the wound in terms of its ability to heal and supervise the healing process. In many of those affected, regular treatment with so-called surgical cleansing (a.k.a. wound toilet or wound debridement), succeeds in ridding the wound of dead skin cells (so-called necrotic tissue) and thus inducing it to recover completely.
In some cases it makes good sense to add a surgical covering procedure, for example in the form of dermato-autoplasty, local or microsurgical flap grafts. By these means, it is possible to get back to a closed, stable soft-tissue covering.
However, even once it has healed, the wound requires professional after-treatment to ensure that there is no scarring of the kind which causes problems.
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