What are actually

Acute and chronic wounds?

Wounds are injuries or damage to the skin or tissue that can be caused by various factors. In the context of allergic skin diseases, wounds can be caused by injuries caused by scratching or rubbing due to itching, for example. There are different types of wounds, including acute and chronic wounds. Acute wounds occur suddenly and usually have a limited duration, whereas chronic wounds are deeper and persist over a longer period of time. The treatment of allergic wounds or wounds in general requires an individualized approach to control the underlying cause, prevent infection and promote the healing process.

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Acute vs. chronic wounds in general

What are acute wounds?

Acute wounds occur suddenly and usually have a limited duration. They often occur as a result of injuries, operations or burns. Acute wounds go through a normal healing phase in which the body actively promotes the healing process. With appropriate treatment and wound care, acute wounds can usually heal within a few days or weeks. During this time, various symptoms may occur, including pain, redness, swelling, warmth and possibly bleeding. The type and severity of the symptoms depends on the individual wound. Adequate treatment and appropriate wound care are crucial to promote the healing process and prevent possible complications.

What are chronic wounds?

The definition of chronic wounds differs in that they are deeper and persist over a longer period of time and do not show a normal healing process. They remain open and do not heal within a reasonable period of about three months. Causes can be circulatory disorders, pressure ulcers, diabetes, venous insufficiency or skin diseases. Chronic wounds are often accompanied by a persistent inflammatory reaction and require specialized treatment to promote the healing process.

The pain intensity of a chronic wound can vary and depends on its size and depth. In addition to pain, reddish to brownish discoloration of the skin may appear around the wound. Itching, weeping or unpleasant odors may occur. Pain can increase if the wound is inflamed or the affected area is moved. Sleep disturbances due to intense perceived pain and itching at night are common.

What are important criteria for the assessment of acute and chronic wounds?

The distinction between acute and chronic wounds is important as they require different treatment approaches. While acute wounds usually respond well to conventional wound care, chronic wounds often require specialized and comprehensive treatment, taking into account the underlying causes.

The following criteria are taken into account in the diagnosis and choice of treatment strategy:

Duration of the wound

Healing process

Underlying causes

Inflammatory reaction

Response to conventional treatment

What does the healing process look like?

In general, wounds typically go through three stages in the healing process. Although most acute wounds heal without complications, there is always a risk of complications such as infection, scarring or inadequate wound closure. Complications can occur in any of the three stages and may lead to chronic wounds.

Inflammation stage

This is the initial stage of wound healing, in which the wound is cleansed and an inflammatory reaction takes place. Redness, swelling, warmth and pain may occur.

Proliferation stage

At this stage, the tissue begins to heal. New tissue is formed, which tightens the wound edges, and new blood vessels are formed to improve wound care.

Maturation stage

This is where the newly formed tissue is consolidated. The scar tissue becomes more stable and the wound gradually closes. However, scarring may continue for some time.

This is the initial stage of wound healing, in which the wound is cleansed and an inflammatory reaction takes place. Redness, swelling, warmth and pain may occur.

At this stage, the tissue begins to heal. New tissue is formed, which tightens the wound edges, and new blood vessels are formed to improve wound care.

This is where the newly formed tissue is consolidated. The scar tissue becomes more stable and the wound gradually closes. However, scarring may continue for some time.

How are chronic wounds treated?

The care of chronic wounds (as well as severe acute wounds) requires comprehensive and specialized treatment. This often requires cooperation between various specialists such as wound experts, nursing staff, dermatologists, vascular surgeons, nutritionists or physiotherapists in order to ensure holistic and individualized treatment.

1. medical evaluation and treatment

Chronic wounds can often be due to underlying conditions such as circulatory disorders, diabetes or skin diseases. Treating these underlying conditions is crucial to improve the healing process. In the case of heavily contaminated wounds or suspected infection (including acute wounds), antibiotic therapy may be necessary.

2. wound cleansing and debridement

The wound is carefully cleaned to prevent possible infection and any dead tissue or debris is removed to promote the healing process.

3. moist wound treatment

A moist wound healing environment is created to support the growth of new tissue and promote wound healing. Special wound dressings or wound gels can be used for this purpose. A wound dressing also serves as protection against re-infection.

4. pressure relief

In the case of pressure ulcers, it is important to relieve the affected area in order to avoid further pressure and support wound healing.

5. pain control

Chronic wounds cause severe pain, which is both physically and emotionally stressful. Appropriate pain therapy with local ointments or systemic medication is therefore an important part of wound care. If necessary, a pain therapist will be consulted.

6. patient support and training

Patients should be informed about the importance of wound care, self-management techniques and preventative measures to promote healing and avoid further wounds.

What can I do myself for acute (or chronic) wounds?

Regular wound checks

Regular monitoring allows changes in the healing process to be recognized and, if necessary, a specialist can be consulted. He can then make adjustments to the treatment. Individual treatment and pain control are particularly important for chronic wounds in order to improve quality of life.

Adequate nutrition

A balanced diet that contains sufficient protein, vitamins and minerals can support the healing process. Nutritional advice or the administration of dietary supplements may be necessary.

Optimization of blood circulation

Smoking impairs blood circulation and oxygen transport in the body, which can have a negative impact on wound healing. Giving up smoking can improve the healing process. Optimizing blood circulation is particularly relevant for chronic wounds, which are often associated with circulatory disorders. Measures such as regular exercise, adequate hydration and, if necessary, the use of compression stockings can promote blood circulation.

Behavioral patterns in the focus of allergic skin diseases

It is important to treat allergic skin conditions early to reduce the risk of wound formation. Appropriate care and treatment of acute and chronic wounds is crucial to alleviate symptoms, restore skin integrity and improve the quality of life of those affected. A holistic approach that includes identifying and avoiding allergens, using topical treatments and supporting the healing process can help to improve the management of allergic skin conditions and the prevention of wounds.

Sources

Please note that all content provided regarding individual medical conditions, treatments, procedures, etc. is general information and may vary depending on the physician:in and individual case and initial situation.
For more detailed information, please always consult your doctor.

Federal health information (n.d.). Chronic wounds

www.gesund.bund.de

Lippert, H.: Wound Atlas: Compendium of Complex Wound Treatment. Georg Thieme Verlag, 2nd edition, 2006.

S3 guideline of the German Society for Wound Healing and Wound Treatment: "Local therapy of chronic wounds in patients with the risks of peripheral arterial occlusive disease, diabetes mellitus, chronic venous insufficiency" Version: 2012.