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Basic principles of wound management

David G Armstrong, DPM, MD, PhD
Andrew J Meyr, DPM
Section Editors
Hilary Sanfey, MD
John F Eidt, MD
Joseph L Mills, Sr, MD
Eduardo Bruera, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


A wound is a disruption of the normal structure and function of the skin and skin architecture [1]. An acute wound has normal wound physiology and healing is anticipated to progress through the normal stages of wound healing, whereas a chronic wound is defined as one that is physiologically impaired [2,3].

To ensure proper healing, the wound bed needs to be well vascularized, free of devitalized tissue, clear of infection, and moist. Wound dressings should eliminate dead space, control exudate, prevent bacterial overgrowth, ensure proper fluid balance, be cost-efficient, and be manageable for the patient and/or nursing staff. Wounds that demonstrate progressive healing as evidenced by granulation tissue and epithelialization can undergo closure or coverage. All wounds are colonized with microbes; however, not all wounds are infected [4,5].

Many topical agents and alternative therapies are available that are meant to improve the wound healing environment and, although data are lacking to support any definitive recommendations, some may be useful under specific circumstances [6,7].

The basic principles and available options for the management of various wounds will be reviewed. The efficacy of wound management strategies for the treatment of specific wounds is discussed in individual topic reviews:

(See "Management of diabetic foot ulcers".)

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Literature review current through: Nov 2017. | This topic last updated: Dec 04, 2017.
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