Advances in Chronic Wound Management: From Conventional Treatment to Novel Therapies and Biological Dressings.

Anisa Andleeb, Hamza Khan, Aneeta Andleeb, Maria Khan, Muhammad Tariq
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Abstract

Chronic wounds can be classified as diabetic foot ulcers, pressure ulcers, or venous leg ulcers. Chronic wound management has become a threat to clinicians and constitutes a major healthcare burden. The healing process of chronic wounds requires many factors to work in concert to achieve optimal healing. Various treatment options, ranging from hypoxia to infection, have evolved considerably to address the challenges associated with chronic wound healing. The conventional and accelerating treatments for chronic wounds still represent an unmet medical need due to the complex pathophysiology of the chronic wound microenvironment. In clinical settings, traditional chronic wound care practices rely on nonspecific topical treatment, which can reduce pain and alleviate disease progression with varying levels of success but fail to completely cure the wounds. Conventional wound dressings, such as hydrocolloids, gauze, foams, and films, have also shown limited success for the treatment of chronic wounds and only act as a physical barrier and absorb wound exudates. Emerging advances in treatment approaches, including novel therapies (stem cells, microRNAs, and nanocarrier-based delivery systems) and multifunctional biological dressings, have been reported for chronic wound repair. This review summarizes the challenges offered by chronic wounds and discusses recent advancements in chronic wound treatment.

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慢性伤口管理的进展:从传统治疗到新型疗法和生物敷料。
慢性伤口可分为糖尿病足溃疡、压疮或腿部静脉溃疡。慢性伤口管理已成为临床医生的一个威胁,也是医疗保健的一个主要负担。慢性伤口的愈合过程需要多种因素协同作用,才能达到最佳愈合效果。为了应对慢性伤口愈合所带来的挑战,从缺氧到感染等各种治疗方案都有了长足的发展。由于慢性伤口微环境的病理生理学十分复杂,慢性伤口的常规治疗和加速治疗仍是一项尚未满足的医疗需求。在临床环境中,传统的慢性伤口护理方法依赖于非特异性的局部治疗,这种治疗方法可以减轻疼痛和缓解疾病进展,并取得不同程度的成功,但无法彻底治愈伤口。传统的伤口敷料,如水胶体、纱布、泡沫和薄膜,在治疗慢性伤口方面的效果也很有限,只能起到物理屏障和吸收伤口渗出物的作用。在慢性伤口修复方面,治疗方法取得了新的进展,包括新型疗法(干细胞、微核糖核酸和纳米载体递送系统)和多功能生物敷料。本综述总结了慢性伤口带来的挑战,并讨论了慢性伤口治疗的最新进展。
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