[Local surgical measures in chronic wounds].

The treatment of chronic wounds is initiated by resection of gangrenous tissue, drainage of abscess formations, and--if necessary--primary resection of necrotic bone and joint structures in the phalanxes. The restoration of arterial blood perfusion in the periphery is a central part of wound management. Several surgical procedures such as necrosectomy, topical application of antiseptic solutions, and hydrocolloid wound dressings serve to create well-vascularized granulative tissue. The application of vacuum occlusive dressings promotes the proliferation of fibroblasts that result in a dense granulative tissue. In the majority of cases, wound closure can be performed by suture traction or with the help of autologous skin grafts.