Chronic problem wounds.

Chronic problem wounds can result from both local and systemic factors that impair wound healing. The only way to achieve successful closure of these wounds is by an accurate diagnosis based on a thorough history, careful physical examination, optimal wound care, control of systemic and/or local factors, and correction of hypoxia. With a careful, planned management protocol, most wounds eventually heal. Recurrence of some wounds, such as pressure sores and venous stasis ulcers, is a tougher challenge in some patients. Prevention is a very important step in these patients. Efforts are underway that may improve the management of chronic nonhealing wounds.