Developments in wound care for difficult to manage wounds.

Research and development in wound healing has ensured that issues relating to chronic wound management remain high in the nursing agenda. Since the advent of modern wound dressings, which retain a moist wound healing environment, work has continued to progress into more advanced, interactive products which aim to alter the wound bed in order to promote a suitable environment for cell migration and growth. Rapid wound healing is advocated and necessary to reduce morbidity and mortality in patients with large chronic wounds and to reduce the financial and manpower implications of long-term wound care in the hospital or community setting. Vacuum-assisted closure, artificial skins, growth factors and larval therapy are discussed in order to give an overview of some of the emerging practices being adopted for difficult to manage wounds.