Tailoring GP management to suit chronic wounds

A holistic and individualised approach is required when managing this potentially burdensome condition

Need to know:

  • Chronic wounds impose significant physical, psychosocial and economic burdens.
  • These wounds fail to progress through orderly phases of repair, and are stuck in an inflammatory state that impedes proliferation.
  • Chronic wounds contain a biofilm of colonising bacteria which alters host immune responses and perpetuates inflammation.
  • The differential diagnoses for causes are broad. Always consider and review the clinical picture to determine whether further investigation for underlying causes is indicated.
  • Consider the goal of treatment, and whether the aim is cure or symptom control, and tailor management and expectations accordingly.
  • Most chronic wound management must take into account the health of the wound bed, the advancing epithelium and the skin surrounding the wound.
  • Manage associated oedema, dependency and exudate to promote healing and prevent recurrence.