Assessment of XXXX : an in-depth discussion of a literature-guided approach.

@entity1 @entity15248 @entity1066 @entity102 @entity3179 @entity4096 @entity6008
@entity3179 represent a significant public health problem that will increase as the population ages. The elderly, the most likely to be afflicted by this condition, present the clinician with special challenges. The diagnosis of @entity3179 involves taking a careful history, paying attention to the existence of factors that predispose individuals to the development of @entity4096 . Clinical features of @entity4096 are important because their recognition allows clinicians to distinguish venous from other chronic @entity1066 . An essential part of the assessment of all @entity1 with chronic wounds is an evaluation of intercurrent diseases, common in the elderly, which may impact on the wound healing process. Thus, in addition to managing @entity4096 and the wound bed, all other factors, systemic and local, that may impede healing need to be investigated and corrected if necessary. Social and psychological issues common to all @entity102 need to be addressed as well. This holistic approach should be standard practice and is applicable to the assessment and management of all @entity6008 . This often requires coordinating a multidisciplinary team of wound healing caregivers. More work needs to be done to clarify a few issues because areas of controversy persist. Although a great deal is known about the effects of @entity15248 on acute wounds, less is known about chronic @entity1066 . Similarly, the role of vitamin supplementation in managing chronic @entity1066 needs further study. Guidelines are needed to determine indications for wound culturing. In addition, more study is required to establish the most effective means of obtaining quantitative cultures. However, the relationship between bacteria and chronic wound healing goes beyond simple quantitation and other factors such as bacterial virulence and host resistance. These controversial issues will be reviewed. Treatment and prevention of @entity3179 will be discussed in a subsequent article.
