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A chronic wound is a wound that does not progress through the normal stages of wound healing—haemostasis, inflammation, proliferation, and remodeling—in a predictable and timely manner. Typically, wounds that do not heal within three months are classified as chronic. [1]
For pain sensitive patients with shallow or irregular wounds, wounds with undermining or explored tracts or tunnels, gauze may be used, while foam may be cut easily to fit a patient's wound that has a regular contour and perform better when aggressive granulation formation and wound contraction is the desired goal. [15]
The card heats to 100.4°F (38°C), bathing the wound in radiant heat. The closely sealed wound covering promotes a moist environment in the wound bed. It is sometimes indicated in wounds that have failed to heal with conventional therapies including wounds with compromised blood flow, diabetic ulcers, and bed sores. [2]
The wound must be of a type that can benefit from the application of maggot therapy. A moist, exudating wound with sufficient oxygen supply is a prerequisite. Not all wound-types are suitable: wounds which are dry, or open wounds of body cavities do not provide a good environment for maggots to feed.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
Some troops leave the battlefield injured. Others return from war with mental wounds. Yet many of the 2 million Iraq and Afghanistan veterans suffer from a condition the Defense Department refuses to acknowledge: Moral injury.
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