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Chronic wounds

Chronic wounds do not progress normally through the stages of healing. Chronic wounds often remain in the inflammatory phase of the healing process, resulting in extended healing times or a complete failure to heal. Achieving healing in chronic wounds is a huge clinical challenge. Chronic wound care is thus a great financial burden to the health care system and causes a significant negative impact on a patient’s life.

 

Aetiologically, chronic wounds can be divided into the following main types:

Pressure ulcers

Pressure ulcers, also commonly known as decubitus or bed sores, are caused when an area of the skin and the tissue below is being put under pressure and blood supply is impaired. Typically, pressure ulcers affect people with limited or inhibited movement of body parts e.g. bedridden or wheelchair bound patients. Patients suffering from neurological conditions, impaired nutrition, poor posture or deformity may also have an increased risk to develop these wounds. Traditional treatment of pressure ulcers mainly involves methods to alleviate the conditions contributing to ulcer development such as support surfaces, repositioning and nutritional support. Moreover, treatment includes promotion of tissue healing (debridement and wound cleansing), protection from contamination, as well as potential surgical intervention.

Venous leg ulcers

Venous leg ulcers develop as a consequence of venous insufficiency. Venous ulceration represents the most common type of leg ulceration. Damaged valves allow blood to pool in the vein, as the vein overfills blood may leak out into the surrounding tissue, leading to a breakdown of the tissue and development of a skin ulcer. The main therapeutic measure for venous ulcer management is compression therapy, as it reduces venous hypertension

Arterial ulcers

Arterial ulcers, also known as ischemic ulcers, are caused by reduced blood supply to the lower extremities and tend to be extremely painful. The most common cause of arterial ulcers is atherosclerosis, but other diseases such as diabetes, thromboangiitis, vasculitis, pyoderma gangrenosum, thalassaemia, and sickle cell disease may further predispose a patient to the development of these wounds. The reduction in arterial blood supply results in tissue hypoxia and concurrent tissue damage

Diabetic Foot Ulcer

Diabetic Foot Ulcer. Diabetes mellitus is one of our most common chronic diseases and its prevalence is still increasing. The life expectancy of diabetics is shortened by up to 15 years, and 75 % die of macrovascular complications. It is estimated that about 10 % of all diabetic patients will have a diabetic foot ulcer at some point of their disease. Diabetes is the most common cause of non-traumatic limb amputation, and patients with such amputations have a 5-year mortality rate of 68 %.

 

Diabetic foot ulcers are further classified as neuropathic (54%), ischemic (10%), or a combination of the two, commonly called neuroischemic (34%). As different therapeutic strategies may be required, differentiating between ischemic and neuropathic diabetic foot ulcers is essential to prevent further complications.

Independent of aetiology, chronic wounds often result in malodour, pain, and infection. This has a negative impact on an individual’s quality of life, including the inability to continue with daily activities such as work, shopping, cooking, exercise and socialising.

 

In general, chronic wound healing is influenced by several local factors such as infection, oxygenation, foreign body invasion, blood supply, as well as by systemic factors such as age, gender, comorbidities, medication, and lifestyle.

 

People with chronic wounds are usually cared for by nurses in their homes, at general practitioner practises, community-based clinics, or in residential care. For many patients healing is not their primary concern, but rather the restriction in their daily life activities. The use of various dressings remains the mainstay in most markets. There is also a range of alternative treatments of chronic wounds. Some are invasive, such as wound debridement and skin substitute therapy, while others are non-invasive, such as compression bandaging, hyperbaric oxygen therapy, negative pressure therapy, ultrasound, and traditional ES therapy.

 

WMCS has proven to be an excellent adjunct treatment for all types of chronic wounds, typically reducing the healing time to 30-50% of that of standard care. It is also pain-free, safe, and easy to administer.
WMCS will provide substantial cost savings in chronic wound care and significantly improve the quality of life for these patients.
Though WMCS has proven to be very effective even for severe hard-to-heal wounds, from an Health Economics perspective the best results are achieved when WMCS is deployed early on in the progression of a chronic wound.

WMCS Case Study from University Hospital of the Ruhr-University of Bochum, Germany