Treatment of wounds of different etiologies

Treatment of wounds of various genesis

Treatment of chronic or difficult to heal wounds is an important stage in the rehabilitation of patients with various diseases; open wounds are painful and hamper the patients' overall progress, preventing effective rehabilitation.

In the wound clinic specialists effectively cope with very different types of wounds:

• Burns. Extensive burn wounds are difficult to heal and require a proactive approach both to treatment and restoration of skin integrity, as well as to the subsequent restoration of the external aesthetic appearance.
• Amputation wounds. These wounds require attention because of their size and because the limb will subsequently be subject to prosthetic support; these conditions impose special requirements on the condition of the wound after it heals.
• Diabetic foot. This is a common and dangerous complication of diabetes, which develops as a result of diabetic angiopathy (reduced blood flow) and neuropathy (reduced sensation). Vascular problems lead to ischemia (lack of oxygen) of the lower extremities, and neuropathy reduces the sensitivity that leads to the situation where the patients do not feel the emergence of the wound. Diabetic foot is a cause of amputation of lower limbs in patients with diabetes.
• Vascular ulcers.These ulcers develop due to irregularities in the blood flow, most often on the lower extremities. In these cases treatment of the underlying causes is required: the restoration of arterial blood flow and removal of stasis in the venous channel. After such surgery Reuth specialists start treatment of ulcers.
• Neuropathic ulcers. This type of ulcer occurs due to sensitivity disorders in skin receptors. As a result, the patient does not feel the emergence of the wounds (cuts, burns, abrasions, blisters) that become infected and turn into deep and difficult to heal wounds. The most common example of such wounds are diabetic foot ulcers.
• Bedsores. These wounds appear in patients who are bed-bound or use a wheelchair for a long time. Soft tissue compression causes disturbance in blood circulation, resulting in wounds, often in areas of large bones (scapula, pelvic area, elbows, spine, thigh). If the sore is left untreated, it can cause death due to sepsis. Treatment of bedsores is long and difficult. Therefore, prevention is the best strategy.

The wound healing process is complex and drawn out. For each patient an individual package of measures aimed at addressing the causes of the wounds, and their healing, is chosen.

• For local treatment various types of bandages are applied: polymer, foam, gel, hydrocolloidal, weed. Most of them protect the wound, maintaining a humid environment and protecting the compromised skin from infection. Often medicated dressings with additions of creams, ointments or solutions containing antibacterial agents and painkilling agents are applied.
• Physical methods: vacuum treatment helps organize wound drainage and increase the blood flow, which speeds up the healing. Ultrasonic treatment facilitates pain reduction, and speeds up healing.
• Injection of medicinal/cell therapy: This treatment uses a combination injection of drugs and macrophages (a type of white blood cell involved in the healing process) to facilitate wound cleaning and tissue regeneration.

Treatment of extensive and complicated wounds requires an integrated approach and the skills of a multiprofessional team including physiotherapists, dieticians, rehabilitation specialists and surgeons. It is preferable to conduct such treatment at the rehabilitation center.