A chronic wound (synonyms: chronic ulcer; chronic skin ulcer; recurrent ulcer; chronic skin ulcer; ICD-10-GM L98.4: Chronic skin ulcer, not elsewhere classified) is said to exist for more than 3 months.
A chronic wound is also said to exist if it has not healed after 8 weeks.
Most frequently, chronic wounds are caused by venous diseases of the legs and by disorders of the blood supply (macro- and microangiopathy).
Regardless of the definition of a chronic wound, the wounds listed below are considered chronic:
- Decubitus – ulcer (ulcer) of the skin or mucous membrane, which is caused by prolonged exposure to pressure.
- Diabetic foot or diabetic foot syndrome – A distinction is made between the neuropathic-infected foot and the ischemic gangrenous foot. In up to 70% of cases, the neuropathic-infected foot is present, in which the peripheral nerves are damaged due to years of deficiency (diabetic neuropathy). The ischemic gangrenous foot is the result of peripheral arterial circulatory disorders, which can lead to necrosis (death) of entire tissue districts. The frequency of occurrence is 20 to 30% of all cases of diabetic foot. The prevalence (disease frequency) of diabetic foot syndrome is 2-10% in the overall diabetic population.
- Ulcus cruris venosum/arteriosum/mixtum, depending on the triggering vessel (lower leg ulcer); prevalence: Ulcus cruris venosum 0.08%; Ulcus cruris arteriosum 3-10%.
- Wounds in peripheral arterial occlusive disease (pAVK).
Causes of these most common reasons for chronic wounds see under the respective disease.
Other chronic wounds are:
- Gangrene (local tissue destruction; a distinction is made between dry and moist gangrene:
- Necrosis (tissue death; blue-black area as a result of evaporation and shrinkage process).
Chronic wounds, venous or arterial, are a disease of older people, that is, those affected are usually older than 70 years.
Course and prognosis: chronic wounds severely affect the quality of life in terms of pain, odor, reduced mobility, frustration, sleep disturbances and even depression. Without appropriate local therapy, a chronic wound will not heal.
