Chronic wounds and their care
There are many patients with chronic wounds. The definition of a chronic wound is that which has not healed in six weeks. As many of us know, wounds of all types close in the space of six weeks. This could be due to small cuts and even abrasions to large wounds in the legs or the abdomen after a bump or an intervention. There are many patients who have been in care during months or years and without results. These wounds can degenerate into deep infections such as osteomyelitis, (Deep infection of the bones), and future loss of limbs.
The local care of the wounds is very important. Many technological advances have been produced to make this care safer and more effective for the patient and the carers. When a wound has stopped healing in the space of six weeks, it is important to stop and re-establish the wound. This is when it is time to consult with experts in healing.
As plastic surgeons, we are the first experts in the healing of wounds. We have the ability to evaluate the wound, but we also dispose of many options to treat them.
We are surgeons that manage the three-dimensional anatomy. This means that we can evaluate a wound from the very bottom of it up to the surface. Not all health professionals can make this approximation as they cannot take the patient into the operating theatre to completely explore the wound and clean it through debridement. The ability to explore the wound is a critical factor to evaluate a chronic wound.
The options available from plastic surgeons include local healing of the wound, negative pressure therapy (VAC), in layers of high technology such as Actcoat, Integra, etc. After this, they have the ability to situate skin grafts that divide the skin or fill it. They also have the ability to move tissue to an area close to the wound that requires new tissue. They are capable of reconnecting blood vessels to all the transplanted tissue which before was impossible. Wounds that have been radiated or chronically infected for years have very few options of treatment.