Chronic Wound Management: The Significance of Evidence and Technology

This book describes how chronic wounds follow a completely different healing trajectory to acute wounds and discusses the factors associated with these poor healing trajectories. These factors include age, chronic inflammation, phenotypic changes in such cells as macrophages, fibroblasts, and keratinocytes, colder, alkaline wound milieu, wound related hypoxemia, and diabetes. Other factors implicated include reperfusion injury, poor patient compliance, presence of undiagnosed and therefore unmanaged biofilms and wound pain.The past decades have yielded reliable evidence-based guidelines and standardized care, but the healing of diabetic foot wounds continues to be unpredictable notwithstanding these advances, while the recurrence rates are also high. The benefits of technology in wound diagnosis are evidence-based and the use of this technology also features in guidelines. However, the same argument cannot be extended to adjuvant devices to facilitate wound closure even though many dev