By Vincent Falanga, MD
Professor of Dermatology and Biochemistry
Boston University School of Medicine
Chairman of Dermatology Department And Training Program, Roger Williams Medical Center

Introduction

Rather suddenly, the term "wound bed preparation" has burst into the wound care field and is already having a tremendous impact on how we approach and think about chronic wounds. One might argue that the term itself is very simple, and some would even wonder what is new about it. Yet, there is little doubt that the focus on wound bed preparation is being successful, for it is galvanizing into renewed action both clinicians and industry for the benefit of our patients. Wound bed preparation as a strategy is allowing us to break into individual components various aspects of wound care, while at the same time maintaining a global view of what we wish to achieve. In this thorough compendium on wound bed preparation, the various aspects needed for achieving it are discussed in detail and should provide clinicians with a very substantial working knowledge of the field. Here in this preface, I have the opportunity to comment on wound bed preparation, why it has become so important, and how it will evolve in the next several years. I regard wound bed preparation as the global management of the wound to accelerate endogenous healing or to facilitate the effectiveness of other therapeutic measures. Specifically, with my comments, I want to differentiate wound bed preparation from wound debridement alone, suggest the need for a more prolonged, maintenance debridement phase, and discuss the importance of eliminating wound exudate. I believe that, ultimately, wound bed preparation will also involve the correction of the wound's biologic microenvironment. This may require the elimination of phenotypically abnormal cells and correction of corrupt matrix components.

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