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The cleansing of chronic wounds

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There is ongoing debate about the differences between chronic and acute wounds. In general, wounds such as leg ulcers, pressure ulcers, diabetic foot ulcers and fungating wounds are classed as chronic wounds. Chronic wounds are contaminated but not necessarily infected.

They take longer than four-to-six weeks to heal and the patient will usually present with underlying pathologies, such as age and illnesses, which contribute to delayed healing. Acute wounds include surgical or traumatic wounds and burns that heal in a timely, orderly manner.1

Wound bed preparation

The term 'wound bed preparation' and the acronym TIME - tissue, infection, moisture and wound edge - are commonly used when discussing wound healing and the importance of preparing the wound bed for healing.2 Wound cleansing is a procedure that has been carried out in wound care for centuries and its aim should be to establish an environment in which to promote healing .3

However, wound cleansing is one aspect of wound care that is often considered to be ritualistic, not evidence-based, and inconsistent.4 This feature sets out to investigate if wound bed preparation is about debridement or if there is a role for wound cleansing.

Debridement is the removal of devitalised (necrotic) or contaminated tissue from the wound and the surrounding area until healthy tissue can be seen.5

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