Dr. Barbara De Angelis is a specialist in Plastic and Reconstructive Surgery, holds a PhD in Regenerative Surgery, and is the author of related scientific articles. She has many years of experience in the care and treatment of chronic ulcers and tissue loss. Often, the presence of these conditions underlies other, undiagnosed conditions, such as uncontrolled diabetes, heart or lung failure, etc.

For these reasons, the evaluation of patients with complex wounds or ulcers must be conducted from both a general and multidisciplinary perspective, including vascular, diabetes, cardiology, internal medicine, and other assessments, supported by chemical and imaging analyses. This multidisciplinary approach allows us to assess the patient from all perspectives and, above all, prevent causes of general deterioration that could lead to a worsening of the local situation.

The local examination involves the objective evaluation of the lesion based on the tissue present (necrotic-fibrinous-granulating), depth (exposure of soft or hard tissue), infection, perilesional area, fluid balance, and edema control (bandaging). Chronic ulcers are losses of substance that do not heal spontaneously within 60 days. Both local factors (e.g., ischemia, infection, repeated trauma, etc.) and systemic factors (e.g., metabolic pathologies, nutritional deficiencies, smoking, etc.) contribute to chronicity.