In these patients, the wound should be treated with a multidisciplinary approach. Progressive chronic wound patients are hospitalized.
In these chronic wound patients, first of all, sugar is corrected and wound treatment is performed. Antibiotics are started according to the culture result. In addition to daily dressing and debridement in wound care, additional treatments such as vacuum therapy, hyperbaric O2 therapy are applied. The vascular structure of the patients should be investigated with necessary examinations and interventions such as USG, CT, angiography. Vascular surgeon intervenes if necessary. Then, the wound under control is closed with grafts if necessary.
There is a 75% risk of re-injury within 5 years. Therefore, it should be followed very closely.
In our clinic, inpatient treatment is applied with a multidisciplinary approach to protect living tissues, eradicate infection and solve the problem with interventions that accelerate healing.
The priorityin chronic wounds is debritman, that is, the removal of dead tissue. If necessary, amputations (dead tissue-blackened tissues) are applied. Necrotic tissues, foreign substances, bacteria and products that cause infection are removed from the environment. Debridement is applied until blood supply is seen in the muscle tissue.
Since infection is one of the main causes of delayed wound healing, antibiotic treatment is started according to the culture result. It is evaluated by internal medicine, internal medicine specialists.
Diabetes treatment of the patient is provided (by internal medicine specialists). Their nutrition is regulated by the dietician.
Psychological support is provided.(Psychiatrist, psychologist)
Vacuum therapy can be applied. It is a dressing method in which localized negative pressure is applied. The dressing is changed every 2-3 days. In addition to these treatments, hyperbaric oxygen and ozone are applied to these patients when necessary.
Hyperbaric O2 therapy is performed in special centers by inhaling 0 O2. Hyperoxygenation of blood and tissues is the main mechanism of action. The main aim of HBO treatment is to provide sufficient O2 to the vascular connective tissue area around the wound and to correct the wound area. While it is very useful in the early period, its effectiveness decreases in advanced periods.
Regional oxygen application is controversial.
Medical ozone application is the regional or systematic application of 0.5-5% ozone / O2 gas mixture. Regionally ozonized material is applied regionally for 15-20 minutes. It has the effect of increasing the production of some growth factors and helping to treat infection. It is systematically taking the patient's blood and ozonizing it. It can also be applied rectally.
Some treatment methods that are still in the research stage are being followed.
Growth factor has a strong effect on wounds. Research is ongoing.
Gene therapy and stem cell applications are still in the early phase. The efficacy and safety of these treatments will be understood as a result of long-term studies.
Pressurized water, ultrasound and radiofrequency methods are being tested in various centers.