Chronic Wounds: From Etiology to Surgical Closure

Chronic wounds are rarely just a local problem. This lecture walks through a systematic approach to assessment—from systemic and vascular factors to the wound itself—and highlights why identifying the underlying cause is often more important than simply treating the wound surface.

The discussion covers practical tools for monitoring healing, including wound scoring systems and photography, assessment of arterial perfusion, diabetic and pressure ulcers, and warning signs that should prompt vascular or oncological investigation. The wound-bed preparation framework of Tissue, Infection, Moisture and Edge provides a useful structure for turning assessment into treatment decisions.

Debridement methods, infection control, modern dressings, negative-pressure therapy and reconstructive closure are compared, including where commonly used approaches may help—and where they may do more harm than good. The lecture also touches on emerging adjuncts such as hyperbaric oxygen therapy and platelet-rich plasma, followed by an engaging discussion of real-world experience and unanswered questions.