New perspectives in the treatment of hard-to-heal wound

Hard-to-heal wounds continue to be a challenge in the everyday surgical practice. Their treatment is time-consuming, expensive and in many cases requires interdisciplinary assessment. Therapy option include properly selected surgical procedures and dressings combined with systemic antibiotherapy. Application of  vacuum assisted closure (VAC) facilitates the evacuation of pathological discharge, reduces tissue oedema and eliminates bacterial biofilm. Complementary administration of antibiotics to control chronic infection relies today in most cases on vancomycin, ciprofloxacin or piperacillin with tazobactam, with good clinical effect. An alternative to antibiotics against MRSA, administered at hospitals might be dalbavancin, a new generation lipoglycopeptide, which belongs to the same class as vancomycin. Introduction of dalbavancin and VAC might be an alternative to traditional methods of therapy.