Importanţa criteriilor microbiologice şi anatomopatologice în clasificarea plăgilor cronice | [The importance of microbiological and pathological criteria in chronic wounds classification]

Abstract

We have conducted a review of the currently available data and we put it together with our own experience in order to highlight the biological processes involved in chronic wounds and the need to adapt the treatment to microbiological and pathological changes proved by specific tests. We introduce the definition of these wounds, their etiology, prevalence, and incidence of risk factors, and the classification based on criteria according to the latest data from the literature. Wounds become chronic after 4-6 weeks. Factors that slow/block wound healing are multiple. Microbial pathogenesis and virulence affect the healing capacity of the host. The development of microbial species in wounds, and the interaction between the pathogenic action of germs and the immune response determine the classification into the following categories: contaminated, colonized, critically colonized, and infected. The diagnosis of chronic wounds is complex. Tissue biopsy and analysis of microbial virulence and pathogenesis are required. Antibiotics must be strictly indicated for cases of wound infection.