ABSTRACT
Michael Walker and Steven Percival ConvaTec Wound TherapeuticsTM, Global Development Centre,
Deeside, Flintshire, U.K.
INTRODUCTION
Invariably, any interruption of the epidermal barrier, whether by accident, warfare, disease or even surgery results in the formation of a wound. Consequently, throughout history the simple act of covering that wound, by whatever means, to effectively duplicate the function of the epidermis, has been understood as a way of protecting the wound from the potentially harmful external environment. In this chapter, the emphasis will be on the recalcitrant nonhealing or “chronic” wound (e.g., leg ulceration). These wounds present an enormous health problem and costs continue to spiral. Present health care costs are thought to be >US$1 billion annually in the United States alone (1). The pathology of these wounds is complex and beyond the scope of the present chapter, but increasingly, commonalities are presented across the three major wound types (e.g., venous ulcers, diabetic ulcers and pressure sores). Each wound may be represented by a combination of factors, which on their own can be deleterious, and if these factors are found collectively they are likely to result in prolonged wound chronicity and increased health care costs.
