Operative debridements of chronic wounds

The term chronic wound does not refer to duration over time, but rather describes a wound that is physiologically impaired. All venous, pressure, and diabetic foot ulcers are defined as chronic wounds. Elderly patients are more likely to experience venous and pressure ulcers,^1-4 which lead to more than half of all lower extremity amputations in persons with diabetes. ⁵ Chronic wounds heal at the same frequency of closure in elderly populations as they do in younger populations, but may heal at a slower rate, primarily because of comorbidities associated with age.^6-9 The comorbidities that delay healing are prevalent among older populations and include venous insufficiency and diabetes. Although there are age-related changes to the skin, it has yet to be shown, clinically, that age alone decreases an elderly person's ability to heal.^7,10,11 A synergistic effect of advanced age and diabetes significantly slows healing.¹²