Unhealing Wounds, The Choice of Surgery When Conventional Procedures Fail

Abstract

Introduction: Wounds that cannot be treated with conventional wound care procedures or those that do not sufficiently get smaller with 6 weeks of treatment are usually considered for reconstructive procedures. The present study reviews surgical procedures based on the reconstructive ladder used for the treatment of difficult wounds that contain cavities or are located on vital organs or tissues and do not heal with standard wound care. This review, which highlights that using conventional techniques in such wounds may be a waste of time and money, is intended to guide health professionals dealing with difficult wounds. Materials and Methods: Between 2018-2023, 37 patients with full thickness wounds due to various etiologies were retrospectively investigated. The etiologies, associated comorbidities, the timing and choice of surgical techniques were reviewed. The wounds which have not demonstrated a decrease in wound diameter with conventional wound care in 6 weeks were included in the study in the study. Results: The mean age of patients was 56.11(32-80) and the sex was male predominantly (%75). The number of surgeries were between 1 and 3 (mean 2). The length of hospital stay after surgery was 3- 7 days (mean 4.2). Surgical wound infection (7), flep failure(3), hematom (2) were seen as complications. Conclusions: Full thickness wounds with deep cavities and wounds over vital structures usually do not respond to conventional wound care efficiently. Wound care specialist should be able to decidewhen to refer or perform surgery the the patients for wound care. In wounds where wound closure is not possible with wound care alone, the patient should be delivered to the most ideal method as soon as possible, taking into account surgical complications.