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Chronic wounds: Treatment consensus

Elof ErikssonHarvard Medical School Boston MA USAPaul Y. LiuDepartment of Plastic Surgery, Rhode Island Hospital Alpert Medical School of Brown University Providence RI USAGregory S. SchultzDepartment of Obstetrics and Gynecology and Institute for Wound Research University of Florida Gainesville FA USAManuela Martins‐GreenDepartment of Molecular, Cell and Systems Biology Laboratory of Wound Healing Biology, University of California Riverside CA USARica TanakaJuntendo University School of Medicine Tokyo JapanDot WeirSaratoga Hospital Center for Wound Healing and Hyperbaric Medicine Saratoga Springs New York USALisa J. GouldDepartment of Surgery South Shore Hospital South Weymouth Massachusetts USADavid G. ArmstrongKeck School of Medicine of University of Southern California Los Angeles CA USAG. W. GibbonsBoston University School of Medicine, Center for Wound Healing South Shore Health Weymouth MA USARandy WolcottSouthwest Regional WCC Lubbock Texas USAOluyinka O. OlutoyeCenter for Regenerative Medicine Abigail Wexner Research Institute, Nationwide Children's Hospital Columbus OH USARobert S. KirsnerDr Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FA USAGeoffrey C. GurtnerStanford University School of Medicine Palo Alto CA USA
2022en
ABI

Аннотация

The Wound Healing Foundation (WHF) recognised a need for an unbiased consensus on the best treatment of chronic wounds. A panel of 13 experts were invited to a virtual meeting which took place on 27 March 2021. The proceedings were organised in the sub-sections diagnosis, debridement, infection control, dressings, grafting, pain management, oxygen treatment, outcomes and future needs. Eighty percent or better concurrence among the panellists was considered a consensus. A large number of critical questions were discussed and agreed upon. Important takeaways included that wound care needs to be simplified to a point that it can be delivered by the patient or the patient's family. Another one was that telemonitoring, which has proved very useful during the COVID-19 pandemic, can help reduce the frequency of interventions by a visiting nurse or a wound care center. Defining patient expectations is critical to designing a successful treatment. Patient outcomes might include wound specific outcomes such as time to heal, wound size reduction, as well as improvement in quality of life. For those patients with expectations of healing, an aggressive approach to achieve that goal is recommended. When healing is not an expectation, such as in patients receiving palliative wound care, outcomes might include pain reduction, exudate management, odour management and/or other quality of life benefits to wound care.

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