Palliative wound care: managing chronic wounds across life's continuum: a consensus statement from the International Palliative Wound Care Initiative.

W individuals of all ages (from neonates to elders) and all socioeconomic groups develop chronic wounds (i.e., a break or chronic ulcer of the skin and underlying tissue that does not respond to medical or surgical interventions). This is particularly true for people living with advanced/end-stage chronic illnesses associated with arterial or venous insufficiency/ edema (e.g., diabetes mellitus, peripheral vascular disease), central and peripheral neurologic disorders causing motor dysfunction and/or sensory deficits (e.g., dementia, stroke, Parkinson’s disease, neurodegenerative disorders), cancers and other diseases leading to cachexia, immunocompromise, chronic infections, or an impaired ability to heal. Even with the best of nursing care, these patients may develop chronic wounds. While wound care has historically focused on curing the underlying disease and healing the wound(s), health care professionals now recognize that chronic wounds are frequently associated with multiple concurrent issues that cause suffering for the patient and her/his family (i.e., those closest to the patient in knowledge, care, and affection). If these are not managed, they may delay wound healing. While most chronic wounds will eventually heal if managed appropriately, some will not. In patients with nonhealable wounds, therapies that aim to heal the wound may not be in anyone’s best interest.