Tailoring GP management to suit chronic wounds

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.