Chronic wounds and their treatment. Skin substitutes and allogeneic transplantations

A chronic wound is the loss of skin and other tissue, which does not heal in the period normally required for treatment of other wounds. Treatment of these wounds may be long and requires specific medical skills. The causes of chronic wounds formation are variegated. The most frequently-observed are venous leg ulcerations, ischemic wounds, diabetic foot ulcerations and decubitus ulcerations. The CEAP classification system has been introduced in order to describe the condition of a person diagnosed with chronic venous insufficiency. Clinical, etiological, anatomical and pathophysiological aspects of the disease are monitored using this classification. Surgical wound cleansing is the basis of all chronic wound treatment. In addition to typical surgical approach, there is a modern, promising methods, such as hydrosurgery and using insect larvae (eg. fly Lucilia sericata). The possibility of replacing the damaged skin areas is significant for proper treatment. An important issue is the development of useful skin substitutes. Research are conducted in many research centers around the world. Medicine and biotechnology lead to the development of many useful skin substitutes, such as Biobrane, Integra, Dermagraft and other. To conclude, the chronic wounds are a crucial problem from the medical viewpoint, but new and effective treatment methods are constantly being developed.