Infected wounds are wounds in which bacteria or other microorganisms have colonized, causing either a delay in wound healing or deterioration of the wound. Most wounds are typically contaminated by bacteria. However, infected wounds result when the body's immune defenses are overwhelmed or cannot cope with normal bacterial growth. An infected wound may be characterized by increased or sustained pain, redness or swelling, pus discharge, bad odor or non-healing of the wound. Persons with decreased immune functions, such as diabetics or the elderly, are at risk for wound infections, since they cannot fight off infections easily. The prevention of wound infection should be a primary management objective for all healthcare practitioners.

An ulcer is a sore on the skin or a mucous membrane, accompanied by the disintegration of tissue. Ulcers can result in complete loss of the epidermis and often portions of the dermis and even subcutaneous fat. The wounds from which ulcers arise can be caused by a wide variety of factors, but the main cause is impaired blood circulation. Especially, chronic wounds and ulcers are caused by poor circulation, either through cardiovascular issues or external pressure from a bed or a wheelchair. A very common and dangerous type of skin ulcers are caused by what are called pressure-sensitive sores, more commonly called bed sores and which are frequent in people who are bedridden or who use wheelchairs for long periods. Other causes producing skin ulcers include bacterial or viral infections, fungal infections and cancers. Blood disorders and chronic wounds can result in skin ulcers as well. Ulcers that heal within 12 weeks are usually classified as acute, and longer-lasting ones as chronic.

Wound infection in diabetic patients is a public health problem. Infection of foot ulcers is commonly seen in diabetic patients and is a substantial morbid event. Diabetic foot ulcer is an open sore or wound that most commonly occurs on the bottom of the foot in approximately 15 percent of patients with diabetes. Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer related complication. Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation such as friction or pressure and trauma, as well as duration of diabetes. The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing, the less chance for an infection

Lymphedema is abnormal swelling caused by a lymphatic system. It is usually found in the arms or legs and can also affect the trunk, face, or genitalia. Primary lymphedema is a congenital problem caused by a decrease in the number or size of the lymphatic vessels. Secondary lymphedema results from damage caused by surgery, radiation therapy, injury, infection, venous insufficiency, scar tissue, cancer and inflammation. It is a result of an accumulation of protein-rich fluid in superficial tissues. Early stages of lymphedema may be temporarily reduced by simple elevation of the limb. Without proper treatment, however, the protein-rich swelling causes a progressive hardening of the affected tissues, along with recurrent cellulitis and possibly fungal infection. In general, the most severe wounds occur in the most advanced stages of lymphedema. Proper diagnosis, early detection and appropriate treatment can effectively slow the progression of Lymphedema

Nutrition plays an essential role in wound healing and wound care practices and nutritional support needs to be considered a fundamental part of wound management. Wound healing is a complex process; it is the process of replacing injured tissue with new tissue produced by the body which demands an increased consumption of energy and particular nutrients, particularly protein and calories. Poor nutrition before or during the healing process may delay healing and impair wound strength, making the wound more prone to breakdown. Neglecting the nutritional health of an individual with a wound can compromise the entire wound management process. Without adequate nutrition healing may be impaired and prolonged. Improved nutritional status enables the body to heal wounds such as the accelerated wound healing seen with nutritional supplementation

Wound dressings and devices form an important segment of the medical and pharmaceutical wound care market worldwide. Dressings are classified in a number of ways depending on their function in the wound (wound debridement, antibacterial agents, occlusive, absorbent, adherence), type of material employed to produce the dressing (e.g. hydrocolloid, alginate, collagen) and the physical form of the dressing (ointment, film, foam, gel). Dressings are further classified into traditional dressings, modern and advanced dressings, skin replacement products and wound healing devices. The ideal dressing should achieve rapid healing at reasonable cost with minimal inconvenience to the patient. Wound care and dressing selection should be a holistic, structured process involving close cooperation between medical and nursing staff. Three factors must be considered when assessing the requirement for a wound dressing which include general health of the patient, local environment of the wound and specific properties of the dressing

Wound healing is a specific biological process related to the general phenomenon of growth and tissue regeneration. Wound healing progresses through a series of interdependent and overlapping stages in which a variety of cellular and matrix components act together to reestablish the integrity of damaged tissue and replacement of lost tissue. Wound healing has four continuous phases including haemostasis, inflammation, proliferation and wound remodelling with scar tissue deposition. In an attempt to reduce the wound burden, much effort has focused on understanding the physiology of healing and wound care with an emphasis on new therapeutic approaches and the continuing development of technologies for acute and long term wound management. The clinician working in wound care needs to become a detective. All possible factors and cofactors that may influence healing must be identified. Due to the multifactorial nature of chronic wounds, a thorough health and physical assessment is mandatory

Wound management is a significant and growing health burden on the community. Wound management can be a complex treatment area, with chronic wounds, acute wounds and surgical wounds each having their own characteristics; but wounds, much like the people affected by them, need to be treated on an individual basis. Successful treatment of difficult wounds requires assessment of the entire patient and not just the wound. Considerable progress has been made on advanced products in the field of wound healing and a number of new therapeutic approaches are now available. It is hoped that continued advances will come about which, when combined with basic medical and surgical approaches, will accelerate the healing of chronic wounds to an extent that is still not possible with current therapeutic agents. It may also be expedient to employ individualized therapeutic approaches for treating specific wound types and individuals using emerging tissue engineering technologies. Such advanced approaches can help treat chronic wounds in a clinically efficient manner

As the science of wound care evolves into a more complex environment, nursing is challenged to meet this complexity. Traditionally and generically, wound healing has been under the patronage of basic nursing care practice encompassing dressings and infection control but also promotion of therapeutic nutrition, mobility, psychosocial support, hygiene, and comfort.  At all levels, in practice settings spanning from critical care through palliative care, from hospitals to battlefield, and from gene therapy to gauze, it is the nurse who is principally caring for patients with wounds.  The role of nursing in wound care from a historical and evolutionary perspective helps to characterize the trend towards advanced practice nursing in the wound care specialty. Delineation of nursing roles consistent with Nursing Education, licensure and certification will enhance collaboration with the wound team and achieve best outcomes for patients

Pain is a typical affair of patients with chronic wounds. Wound infection can postpone healing and cause and intensify wound pain. The principle underlying cause of infection associated wound pain is the inflammatory reaction stimulated through the infecting. This response motives the discharge of inflammatory mediators and stimulates the creation of enzymes and free radicals, which can cause tissue damage. Dressing changes are a predominant contributor to wound pain.   Pain management must encompass pain evaluation before, during and after each dressing change to make sure that the affected person’s pain is managed successfully. Such progressing assessment will allow healthcare professionals to identify any triggers that can be modified or avoided to reduce pain.

The non-healing wounds occur when the level of oxygen in and across the wound drops under a particular stage and your body's natural cure system and ability to battle infection emerge as generally impaired. Chronic wounds such as these require specialized wound care and mostly, hyperbaric remedy healing. Patients who can benefit from hyperbaric oxygen therapy include Patients with non-healing wounds, Cancer patients with tissue damage as a result of radiation therapy, certain advanced diabetic foot wounds and chronic bone infections. Hyperbaric oxygen treatments in chosen patients can facilitate healing by increasing tissue oxygen tension, thus providing the wound with more favorable conditions for repair. Therefore, HBO therapy can be most important factor to any comprehensive wound care program.

The field of regenerative Medicine has been focusing cutting edge innovations to heal cutaneous wounds. There are various regenerative medicine advancements being researched for the treatment of skin diseases, wounds and burns. The larger part of innovations is being produced for the treatment of ulcers connected with diabetes and chronic or complex wounds. Regenerative Medicine including cellular therapy and tissue engineering is a quickly developing field that is being examined as an option for the restoration of function in many diseases. The application of stem cells to wounds is advantageous, as stem cells have the ability to differentiate and replace the lost or damaged tissue, as well as influence multiple biological pathways at once via paracrine signaling. Stem cell biology and regenerative medicine are rapidly expanding fields and the emergence of novel stem cell populations have allowed researchers to take an approach to the study of specific diseases and biological processes.

The treatment of burn wounds has evolved over many years via clinical and preclinical studies. Big advancements were made in patient care, which include monitoring wound healing, developing novel graft and coverage options, inflammation control, dietary needs optimization, and testing unique pharmacological interventions. Current techniques to burn management are based totally on an understanding of the biology and body structure of human skin and pathophysiology of the burn wound. Improvements are also needed to accelerate wound closure, healing and to improve mental care to promote successful reintegration. Studies in infection, contamination, stem cells, grafting, biomarkers, infection control, and rehabilitation will maintain to enhance individualized care and create new treatment options. Future studies will maintain to discover novel goals and treatment paradigms to enhance burn wound care.