[Non-healing wounds]. / Een wond aan het been die niet geneest.

ABSTRACT

The incidence of non-healing wounds is increasing. Identification of the underlying cause of a wound is of essential importance for adequate treatment. In this article, we present three female patients aged 50, 65 and 85 years with respectively pyoderma gangraenosum, livedoid vasculopathy and Martorell hypertensive ischaemic leg ulcer. All patients were treated with local wound care for weeks without a valid diagnosis. In retrospect it can be concluded that several warning signals had not been recognised. Severe pain, atypical location or appearance, insufficient healing and progression of the wound despite adequate wound care should all be considered red flags. Patients with non-healing wounds require prompt referral and more extensive diagnostic investigation. Our cases also show that a multidisciplinary wound care team ensures and accelerates consensus on diagnosis and treatment plan. Such a team can ensure and coordinate follow-up in the home environment.