**Author details**

B. Gastrointestinal fistulation

356 Wound Healing - New insights into Ancient Challenges

D. Direct exposure of large blood vessels due to risk of bleeding

**11.2. Adjunctive measurements contributing to wound management**

1. Ultrasound waves, electrotherapy or laser therapy. These adjuncts have always been thought to contribute towards better wound management. In a recent RCT, Cullum et al. concluded that there is lack of sufficient reliable evidence to draw conclusions about the contribution of laser therapy, therapeutic ultrasound, electrotherapy and electromagnetic therapy to chronic

2. Hyperbaric oxygen therapy. Tissue hypoxia is one of the characteristics of chronic wounds. Therefore, means of increasing O2supply to tissues could potentially improve chronic wound healing. In a recent Cochrane review of 12 randomised trials, it was concluded that hyperbaric O2 therapy can improve the chance of healing of diabetic foot ulcers only on short term but not on long term bases [31]. It can also reduce the size of wounds caused by chronic venous insufficiency but it was found to have no effect in wounds/ulcers caused by arterial insuffi-

After reading this chapter the reader would have full understanding of types of wounds (WHO Classification) and how to treat them. We have described in details how to deal with different types of wound from clean surgical wound to heavily contaminated wounds. Closure of wounds by primary intention when the wound is clean and debridement and then leaving the wound to heal by secondary intention with or without secondary closure with sutures as deemed necessary. Different types of dressings are described in details with pros and cons of each one of them. Role of all personnel involved in treating the wound is defined. More specific types of method, i.e. laser therapy, ultrasound, hyperbaric oxygen and compression used for treating the wound are enumerated but not described in details as there is not enough evidence

We would like to express our sincere thanks to Dr Jaina Chauhan and Miss Janaki Solanki for poof reading the article and making linguistic changes where necessary. We would also like to

acknowledge the help provided by Miss Shona Stewart in co-ordinating the project.

C. Untreated osteomyelitis

E. Thick/necrotic eschar.

wound healing [30].

ciency [31].

available.

**Acknowledgements**

**12. Conclusion**

Peter Mekhail1 , Shuchi Chaturvedi2 and Shailesh Chaturvedi3\*

\*Address all correspondence to: s.chaturvedi@nhs.net

