Management of Chronic Wounds: With Focus on Diabetic Ulcers

Abstract

In this chapter, the author attempts to help readers understand the overall treatment of chronic wounds by describing a diabetic foot, one of representative chronic wounds. An accurate understanding of a diabetic foot would also be of great help for the treatment of other types of chronic wounds. In chronic wounds, wound healing cannot often be achieved successfully because of the involvement of multiple factors. Since the clinical characteristics of diabetic feet are very diverse and diabetic patients display a variety of diabetic complications, it is probable that they present all the characteristics of other chronic wounds. There are four representative factors that make it difficult to treat patients with diabetic ulcers. These four factors are termed VIPS. VIPS is the author’s handy treatment tool. The letters stand for vascularity, infection, pressure injury, and source of healing (cell function for wound healing). The management of ischemia and pressure injury is described in this chapter. The management of infection and source of healing are briefly outlined here, and more details will be described in the following chapters.