Prepoznavanje i liječenje infekcije kronične rane iznimno je kompleksan posao pri kojem je nužan timski rad i svrsishodno postupno rješavanje problema. infekcija kronične rane je najrizičnija komplikacija, jer može dovesti do smrti bolesnika. principi najbolje kliničke prakse obuhvaćaju temeljitu obradu bolesnika s obzirom na endogene bolesti i čimbenike rizika, definiranje mjesta infekcije i karakteristika rane uz kliničke simptome infekcije. temeljem statusa rane indiciraju se dijagnostički postupci i utvrđuje uzročnik i njegova osjetljivost na antibiotike. S obzirom na težinu kliničke slike radi se plan kirurških intervencija, gdje je temeljni postupak debridement ili se primjenjuju potporne metode liječenja, a izbor ovisi o indikacijama i kontraindikacijama. Ciljana metoda liječenja infekcije je sistemska primjena antibiotika uz debridement. značajno je da pri radu s kroničnom inficiranom ranom moramo poštivati principe asepse i antisepse. U kliničkoj praksi postoji raskorak između prihvaćenih kriterija učinkovitog liječenja temeljenog na „evidence base practice“ te objektivnih i subjektivnih problema koji to onemogućuju. tako se prema statističkim podatcima 50 % antibiotika netočno propisuje, izgubi ili propadne, a samo polovica bolesnika se liječi korektno. vrijeme je konsenzusa i prihvaćanja činjenica koje su značajne za liječenje kronične inficirane rane, tj. „medicine temeljene na dokazima“.Recognition and treatment of a chronic wound infection is an extraordinarily complex task that requires team work and purposeful and graduate resolving of the problem. Chronic wound infection is the most risky complication because it may have fatal outcome for the patient. The principles of best clinical practice include thorough examination of the patient with respect to endogenous diseases and risk factors, defining the locality of infection and wound characteristics, along with clinical symptoms of infection. Based on the wound status, diagnostic procedures are initiated and the causative agent and its sensitivity to antibiotics determined. With respect to the seriousness of the clinical picture, a plan of surgical interventions is developed. The main procedure is debridement, followed by supportive treatment methods, the choice depending on the indications and contraindications. The targeted method of treatment is systemic administration of antibiotics along with debridement. It is important to know that on approaching a chronic infected wound, the principles of sepsis and antisepsis should be observed. In clinical practice, there is a discrepancy between the adopted criteria for efficient treatment based on the evidence-based practice and objective and subjective problems that obstruct it. Thus, according to statistical data, 50% of antibiotics are prescribed wrongly or are rendered inefficient for some reason. Only half of the patients are treated correctly. It is high time to reach consensus on this issue and accept the facts relevant for the treatment of chronic infected wound, i.e. evidence-based medicine
