Table of Contents
Ulcers
Volume 2013 (2013), Article ID 625934, 8 pages
http://dx.doi.org/10.1155/2013/625934
Review Article

What Is New in the Understanding of Non Healing Wounds Epidemiology, Pathophysiology, and Therapies

1Department of Clinical Microbiology 9301, Juliane Mariesvej 22, Copenhagen University Hospital, DK-2100 Copenhagen, Denmark
2Department of International Health, Immunology, and Microbiology, Faculty of Health Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
3Department of Orthopedic Surgery, Hvidovre University Hospital, DK-2650 Copenhagen, Denmark

Received 20 November 2012; Accepted 9 April 2013

Academic Editor: Marisa Herson

Copyright © 2013 H. Trøstrup et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic wounds are a growing socioeconomic problem in the western world. Knowledge on recalcitrant wounds relies on in vitro studies or clinical observations, and there is emerging evidence on the clinical impact of bacterial biofilm on skin healing. Chronic wounds are locked in the inflammatory state of wound healing, and there are multiple explanations for this arrest with the theory of exaggerated proteolysis as the most commonly accepted. Previously, there has not been enough focus on the different etiologies of chronic wounds compared to acute, healing wounds. There is an urgent need to group chronic wounds by its cause when searching for possible diagnostic or therapeutic targets. Good wound management should therefore consist of recognition of basic wound etiology, irrigation, and debridement in order to reduce microbial and necrotic load, frequently changed dressings, and appropriate antimicrobial and antibiofilm strategies based on precise diagnosis. Representative sampling is required for diagnosis and antimicrobial treatment of wounds. The present review aims at describing the impact of biofilm infections on wounds in relation to diagnosing, treatment strategies, including experimentally adjuvant approaches and animal models.