An Update on Management of Acute and Chronic Open Wounds: The Importance of Moist Environment in Optimal Wound Healing

Wound healing is a complex process that can be compromized by both endogenous and exogenous factors. The old dictum “I dressed the wound, God healed it” is from the past. There is ample evidence now to suggest that local wound management greatly affects the orderly progression of the healing cascade and determines the quality of its final outcome. The perfect wound dressing would relieve pain, provide a moist wound environment, shield the wound from further damage, remove necrotic debris, promote granulation tissue formation and protect the wound from bacterial contamination. There are currently hundreds of topical preparations and dressings on the market to aid in wound management. Over the years, biologically neutral agents that would allow the healing process to proceed unhindered by providing optimal conditions, have replaced older preparations proven to affect negatively wound healing. Bio-pro-active products are being developed and will be the future generation of local wound care agents in future. In any event, the bestinformed choice for the patient must always be made. However, surgical vascular and soft tissue reconstruction should not be overlooked whenever indicated by insisting on unsuccessful local wound therapies.