Fundamental Aspects of the Local Approach to Cutaneous Ulcers

Overview

Journal An Bras Dermatol

Specialty Dermatology

Date 2018 Nov 29

PMID 30484531

Citations 5

Authors

Raquel Colenci

Luciana Patricia Fernandes Abbade

Affiliations

Soon will be listed here.

Abstract

Ulcers or wounds can be classified as acute or chronic. Their treatment involves overall assessment of the patient and choice of suitable local therapy, and the appropriate indication and use of products. Technological progress in the field of wound treatment has increased rapidly. Constant updating, with emphasis on available scientific evidence, is necessary to offer the best approaches to patients with acute and chronic wounds. A qualitative analysis of literature was conducted to identify scientific publications that update the concepts involved in local wound treatment, to present some resources that can aid the healing process and describe the different types of dressings available. This review includes wound assessment using the acronym TIME (tissue, infection/inflammation, moisture balance and edge of wound), cleaning and debridement, infection/inflammation control, exudate control, dressing types and main indications.

Citing Articles

Clinical Presentation and Integrated Management of Pressure Injuries in the Emergency Hospital Setting: A Plastic Surgeon's Perspective.

Cacior S, Bordeanu-Diaconescu E, Ratoiu V, Grosu-Bularda A, Hodea F, Al-Falah K Healthcare (Basel). 2025; 12(24.

PMID: 39766011 PMC: 11728046. DOI: 10.3390/healthcare12242583.

The Antibacterial and Wound Healing Properties of Natural Products: A Review on Plant Species with Therapeutic Potential against Wound Infections.

Morguette A, Bartolomeu-Goncalves G, Andriani G, Bertoncini G, Castro I, Spoladori L Plants (Basel). 2023; 12(11).

PMID: 37299127 PMC: 10255540. DOI: 10.3390/plants12112147.

Collagen-Based Nanofibers for Skin Regeneration and Wound Dressing Applications.

Mbese Z, Alven S, Aderibigbe B Polymers (Basel). 2021; 13(24).

PMID: 34960918 PMC: 8703599. DOI: 10.3390/polym13244368.

Safety of Silk-elastin Sponges in Patients with Chronic Skin Ulcers: A Phase I/II, Single-center, Open-label, Single-arm Clinical Trial.

Noda K, Kawai K, Matsuura Y, Ito-Ihara T, Amino Y, Ushimaru M Plast Reconstr Surg Glob Open. 2021; 9(4):e3556.

PMID: 33936917 PMC: 8081464. DOI: 10.1097/GOX.0000000000003556.

Consensus on the diagnosis and management of chronic leg ulcers - Brazilian Society of Dermatology.

Abbade L, Cipriani Frade M, Pegas J, Dadalti-Granja P, Garcia L, Bueno Filho R An Bras Dermatol. 2020; 95 Suppl 1:1-18.

PMID: 33371937 PMC: 7772605. DOI: 10.1016/j.abd.2020.06.002.

References

Gethin G, Cowman S, Kolbach D . Debridement for venous leg ulcers. Cochrane Database Syst Rev. 2015; (9):CD008599. PMC: 6486053. DOI: 10.1002/14651858.CD008599.pub2. View

Lin W, Lien C, Yeh H, Yu C, Hsu S . Bacterial cellulose and bacterial cellulose-chitosan membranes for wound dressing applications. Carbohydr Polym. 2013; 94(1):603-11. DOI: 10.1016/j.carbpol.2013.01.076. View

Falabella A, Carson P, Eaglstein W, Falanga V . The safety and efficacy of a proteolytic ointment in the treatment of chronic ulcers of the lower extremity. J Am Acad Dermatol. 1998; 39(5 Pt 1):737-40. DOI: 10.1016/s0190-9622(98)70045-3. View

. Clean vs. sterile dressing techniques for management of chronic wounds: a fact sheet. J Wound Ostomy Continence Nurs. 2012; 39(2 Suppl):S30-4. DOI: 10.1097/WON.0b013e3182478e06. View

OMeara S, Al-Kurdi D, Ologun Y, Ovington L, Martyn-St James M, Richardson R . Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014; (1):CD003557. PMC: 10580125. DOI: 10.1002/14651858.CD003557.pub5. View

Tallis A, Motley T, Wunderlich R, Dickerson Jr J, Waycaster C, Slade H . Clinical and economic assessment of diabetic foot ulcer debridement with collagenase: results of a randomized controlled study. Clin Ther. 2013; 35(11):1805-20. DOI: 10.1016/j.clinthera.2013.09.013. View

Lipsky B, Hoey C . Topical antimicrobial therapy for treating chronic wounds. Clin Infect Dis. 2009; 49(10):1541-9. DOI: 10.1086/644732. View

Harries R, Bosanquet D, Harding K . Wound bed preparation: TIME for an update. Int Wound J. 2016; 13 Suppl 3:8-14. PMC: 7949772. DOI: 10.1111/iwj.12662. View

McCallon S, Weir D, Lantis 2nd J . Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement. J Am Coll Clin Wound Spec. 2015; 6(1-2):14-23. PMC: 4566869. DOI: 10.1016/j.jccw.2015.08.003. View

10.

Eberlein T, Assadian O . Clinical use of polihexanide on acute and chronic wounds for antisepsis and decontamination. Skin Pharmacol Physiol. 2010; 23 Suppl:45-51. DOI: 10.1159/000318267. View

11.

Saco M, Howe N, Nathoo R, Cherpelis B . Topical antibiotic prophylaxis for prevention of surgical wound infections from dermatologic procedures: a systematic review and meta-analysis. J Dermatolog Treat. 2014; 26(2):151-8. DOI: 10.3109/09546634.2014.906547. View

12.

Pereira A, Bachion M . [Wound treatment: scientific production analysis published in the Revista Brasileira de Enfermagem from 1970-2003]. Rev Bras Enferm. 2005; 58(2):208-13. DOI: 10.1590/s0034-71672005000200016. View

13.

Omar A, Wright J, Schultz G, Burrell R, Nadworny P . Microbial Biofilms and Chronic Wounds. Microorganisms. 2017; 5(1). PMC: 5374386. DOI: 10.3390/microorganisms5010009. View

14.

Back D, Scheuermann-Poley C, Willy C . Recommendations on negative pressure wound therapy with instillation and antimicrobial solutions - when, where and how to use: what does the evidence show?. Int Wound J. 2013; 10 Suppl 1:32-42. PMC: 7950486. DOI: 10.1111/iwj.12183. View

15.

VerMeulen H, Westerbos S, Ubbink D . Benefit and harm of iodine in wound care: a systematic review. J Hosp Infect. 2010; 76(3):191-9. DOI: 10.1016/j.jhin.2010.04.026. View

16.

Tayyib N, Coyer F . Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review. Worldviews Evid Based Nurs. 2016; 13(6):432-444. DOI: 10.1111/wvn.12177. View

17.

Klein S, Schreml S, Dolderer J, Gehmert S, Niederbichler A, Landthaler M . Evidence-based topical management of chronic wounds according to the T.I.M.E. principle. J Dtsch Dermatol Ges. 2013; 11(9):819-29. DOI: 10.1111/ddg.12138. View

18.

Akhmetova A, Saliev T, Allan I, Illsley M, Nurgozhin T, Mikhalovsky S . A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds. J Wound Ostomy Continence Nurs. 2016; 43(6):598-609. PMC: 5098468. DOI: 10.1097/WON.0000000000000273. View

19.

Atkin L, Rippon M . Autolysis: mechanisms of action in the removal of devitalised tissue. Br J Nurs. 2016; 25(20 Suppl):S40-S47. DOI: 10.12968/bjon.2016.25.20.S40. View

20.

Cipriani Frade M, Netto J, Gomes F, Mazzucato E, de Andrade T, Foss N . Natural-biomembrane dressing and hypersensitivity. An Bras Dermatol. 2011; 86(5):885-91. DOI: 10.1590/s0365-05962011000500004. View