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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 ]
The wound-healing process is not only complex but fragile, and it is susceptible to interruption or failure leading to the formation of non-healing chronic wounds. Factors that contribute to non-healing chronic wounds are diabetes, venous or arterial disease, infection, and metabolic deficiencies of old age. [4]
Chronic wound exudate contains proteolytic enzymes and other components that degrade skin integrity and predispose it to inflammation. [ 8 ] [ 9 ] Moisture-associated skin damage can also be caused by bodily fluids or other contaminants that enter the periwound areas, for example, in patients with urinary or fecal incontinence , or colostomy ...
Wound assessment is a vital first step in the precision management process. The purpose of wound assessment is: To identify: the origin of the wound, the effects of the wound on the individual, the effects of the individual on the wound. To determine: if healing is taking place, the most appropriate management of the wound. To gather data:
The end goal of wound management is closure of the wound which can be achieved by primary closure, delayed primary closure, or healing by secondary intention, each of which is discussed below. Pain control is a mainstay of wound management, as wound evaluation, wound cleansing, and dressing changes can be a painful process. [27]
Clinical nutrition centers on the prevention, diagnosis, and management of nutritional changes in patients linked to chronic diseases and conditions primarily in health care. Clinical in this sense refers to the management of patients, including not only outpatients at clinics and in private practice, but also inpatients in hospitals.
A week after the injury, the edges of the wound are pulled together by contraction. Contraction is an important part of the healing process when damage has been extensive, and involves shrinking in size of underlying contractile connective tissue, which brings the wound margins toward one another. [1]
Negative pressure wound therapy device. Negative-pressure wound therapy (NPWT), also known as a vacuum assisted closure (VAC), is a therapeutic technique using a suction pump, tubing, and a dressing to remove excess wound exudate and to promote healing in acute or chronic wounds and second- and third-degree burns.
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