Evidenz in der lokalen Therapie chronischer Wunden: Was ist gesichert?

Chronic wounds are a comprehensive symptom of various underlying diseases. For example, they can be vascular, metabolic or immunological in nature. Even if the therapy of these underlying diseases is in the focus, these wounds have a great impact on the quality of life of the individual patient. A broad portfolio of choices is available for the local therapy of chronic wounds. In contrast to other fields of medicine, the evidence for the various local therapeutic options is mostly limited. Therefore, expert recommendations, guidelines, and directives are replacing them to provide reasonable treatment pathways. The most important issues in daily practice relate to the choice and efficacy of wound irrigation and debridement, exudate management, the use of antimicrobial agents in solutions and wound dressings, negative pressure wound therapy (NPWT), and the indications for compression therapy. Despite the lack of evidence, the management of chronic wounds adheres to some fundamental principles, which are outlined in the following article, including the related treatment recommendations.