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Histopathology of Wounds

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Measurements in Wound Healing

Abstract

It is difficult to conduct systematic reviews of the literature reporting on histopathology of non-healing chronic wounds since data are mainly from clinical reports and trials. In this chapter the authors summarize their experience of the pathology of chronic wounds and review the available literature to update the current understanding of the pathogenesis of impaired wound healing. Chronic wounds have diverse etiologies some 90% being of venous, pressure and diabetic ulcers. Detailed explanations of their histologic features are provided in this chapter. New immunohistochemical and special stains of potential value for the diagnosis and treatment are discussed. Other less commonly encountered causes for non-healing ulcers include calciphylaxis, radiation ulcers, Pyoderma gangrenosum, factitial ulcers, infections, as well as vasculitis and vasculopathy.

Attempts should be made to distinguish vasculitis from vasculopathy as this requires different therapeutic approach as well these two primary vascular diseases from pseudovasculitis and pseudovasculopathy which are common secondary epiphenomena in biopsies from chronic wounds. Finally, to exclude clinical doubts about malignancy in a chronic ulcer, it is essential to sampling of the ulcer at several wound sites (margins and base) and at several time points and to seek a confirmatory tissue diagnosis.

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Author information

Authors and Affiliations

  1. Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave., 33136, Miami, FL, USA

    Mariya Miteva M.D. & Paolo Romanelli M.D.

Authors
  1. Mariya Miteva M.D.
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  2. Paolo Romanelli M.D.
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Correspondence to Paolo Romanelli M.D. .

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Editors and Affiliations

  1. School of Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD, United Kingdom

    Raj Mani

  2. Centro SERRA, Università di Pisa, Lungarno Pacinotti 43, Pisa, 56100, Italy

    Marco Romanelli

  3. Banaras Hindu University, Varanasi, New F. Jodhpur Colony 6, Varanasi, 221 005, India

    Vijay Shukla

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© 2012 Springer-Verlag London

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Miteva, M., Romanelli, P. (2012). Histopathology of Wounds. In: Mani, R., Romanelli, M., Shukla, V. (eds) Measurements in Wound Healing. Springer, London. https://doi.org/10.1007/978-1-4471-2987-5_9

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  • DOI: https://doi.org/10.1007/978-1-4471-2987-5_9

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2986-8

  • Online ISBN: 978-1-4471-2987-5

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