Chronic ulcers result from neoplasms, vascular injury, debilitation, and neurological conditions where the patient is unaware of injury to the affected part. An ulcer is an area of loss of the epithelium, with acute or chronic inflammation in the underlying connective tissue. Ulcers may be acute or chronic, depending upon the nature of the inflammatory process. In acute ulcer, the epithelium is lost and there is edema, congestion, and polymorphonuclear leukocyte infiltration in the underlying tissue. Grossly, there is a breach in the epidermis with acute or chronic granulation tissue below.
Acute ulcers show evidence of acute inflammation.
Chronic ulcers have chronic granulation tissue at the base. Depending upon the cause, acute ulcers are self-limiting with appropriate treatment. Chronic ulcers, especially if large, need replacement of the ulcer bed and skin grafting to provide fresh epithelium to grow over the affected area. 562 Search Medline at National Library of Medicine Please be patient during transfer. Medline will open in a new window.