Complex Wound Management - PubMed

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.

2023 Jul 4.

Wound healing is a complex dynamic biomechanical process as the body attempts to restore the integrity of traumatized or devitalized tissues. Chronic wounds are defined as longstanding tissue injuries that cannot be treated with conventional methods of wound dressing or closure either due to local tissue factors or systemic factors.

Recently, chronic wounds have been described as “complex wounds,” a term more representative of the multifactorial dynamic tissue healing process. For a wound to be classified as a complex wound, it should show one of the following features:

1. Persistent for more than three months

2. Compromised vascularity or necrosis

3. Presence of infection

4. Associated comorbidities impair healing potential

There are many factors, both local and systemic, that can affect wound healing. Local factors include wound depth, infection, peripheral vascular disease, radiotherapy, sustained pressure, and excessive moisture. While systemic factors include metabolic disorders such as diabetes mellitus, immunodeficiency, and nutritional deficiencies.

Complex wounds cause a huge burden on both the individual level (health-related quality of life) and the institutional level (economic cost). It is estimated that 1 to 3% of the health care expenses in developed countries go for complex wound management. This represents around the US $25 billion a year in the united states. This figure is subjected to further increase as the number of chronic morbidities rises in the community.

Disclosure: Amir Labib declares no relevant financial relationships with ineligible companies.

Disclosure: Ryan Winters declares no relevant financial relationships with ineligible companies.

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