Modern Approaches to the Surgical Treatment of Complicated Wounds Considering Innovative Technologies and European Experience (Literature Review)

Complicated wounds remain a significant challenge in modern medicine due to their prolonged course, persistent inflammation, high risk of infection, and difficulties in treatment. They most commonly occur in patients with diabetes mellitus, vascular pathologies, pressure ulcers, and other chronic diseases, which complicates healing and increases the risk of severe complications, including amputation. Traditional treatment methods, such as medication therapy, wound dressings, and surgical interventions, are not always sufficiently effective, necessitating the implementation of innovative strategies. Recent studies highlight the potential of cellular therapies, particularly mesenchymal stromal cells, which promote tissue regeneration, stimulate angiogenesis, and modulate inflammatory processes. Bioengineered skin substitutes have demonstrated high efficacy in accelerating wound closure and improving healing outcomes. Platelet-rich plasma with its high concentration of growth factors, enhances cell proliferation and tissue remodeling, making it an important component of modern therapy. The European experience in the treatment of complicated wounds confirms the effectiveness of a multidisciplinary approach, involving close collaboration between surgeons, endocrinologists, physiotherapists, and wound care specialists. This approach enables timely detection of complications, effective infection control, and optimized treatment strategies. A crucial element of modern wound management is the integration of digital technologies, including telemedicine and artificial intelligence, which provide personalized monitoring of the healing process. Despite significant advancements in the treatment of complicated wounds, the widespread adoption of innovative technologies remains limited due to high costs and the necessity for specialized medical training. The further development of this field involves adapting European treatment protocols, expanding access to bioengineered materials, improving regenerative technologies, and enhancing comprehensive patient care strategies.