Differentiated local therapy of chronic wounds with modern wound dressings

The therapy of chronic wounds comprises besides treating the underlying disease, for instance compression therapy and phlebosurgery with venous ulcus cruris modern differentiated local therapy. Conventional wound therapy comprises primarily of colour solutions, various ointments, local antimicrobial agents, and sterile pressure bandages. Although it has been proven that conventional methods impede wound healing compared with modern wound dressings they are still widely used. In comparison the principle of moist wound healing is the basis of modern differentiated wound therapy. Therefore a vast number of modern wound dressings has been established in the last years. As not every wound dressing is suitable for every type of wound the knowledge of available modern wound dressings is essential in order to choose the wound dressing which is most suitable for the individual case. In the exsudation/cleaning phase polyurethane foams, alginates and dressings containing activated charcoal are indicated They can also be used in the granulation phase. The granulation phase is main indication for hydrokolloids and hydrogens. They are also used beside nonadhesive dressings and alginates in the epithelialisation phase. Besides the above synthetic wound dressings cytokines and biological skin equivalents are increasingly used in modern wound therapy. Biological skin equivalents comprise of epidermis equivalents, dermis substitutes and combined epidermis-dermis equivalents which are being developed at present. These will possibly be more effective on wound closure. Phase adapted use of modern wound dressings enables acute and chronic wounds to heal quickly and without complications. Present clinical studies are evaluating the importance of cytokines and new vital skin substitutes, which might offer interesting possibilities for further improvement in wound treatment.