title: [Challenges of aging skin: Care and therapy using the example of venous ulcers].
abstract: BACKGROUND
  One of the most significant, and growing, challenges in modern medicine, i.e. the treatment of chronic wounds, is marked by nonuniform data. This concerns both prevalence and incidence of chronic dermatosis, in particular venous ulcers (ulcus cruris), as well as the impact on the health-related quality of life, and practical and economic parameters of the success of different therapies.
  
  
  OBJECTIVE
  The aim of this work is to examine the epidemiology of chronic wounds, in particular age-associated venous ulcers, their impact on health-related quality of life, the treatment regimen, and practical and economic parameters of the success of different therapies.
  
  
  METHODS
  Performed were analysis of data on the care of venous ulcers in Germany, based on secondary data of Barmer GEK from 2009 and 2012, comparison with data of a NHS Kent Community Health Trust study, and analysis of studies concerning structures, processes and critical success factors for the treatment of chronic wounds, including economic effects.
  
  
  CONCLUSIONS
  Early causal therapy with treatment based on the stage of the wound, consequent goal-oriented interdisciplinary care, and relapse prophylaxis is critical for successful healing of venous ulcers. The costs of treatment significantly correlate with the duration of treatment which can be reduced by up to 60% using guideline-based concepts for the treatment of chronic wounds. Treatment success, in particular with regard to cost-benefit considerations, can be optimized by telemedicine networks of key players who treat chronic wounds.
authors.affiliation: Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland. m.augustin@uke.de.
authors.forename: M
authors.initials: M
authors.lastname: Augustin
authors.affiliation: WU Executive Academy, Wirtschaftsuniversität Wien, Wien, Österreich.
authors.forename: G
authors.initials: G
authors.lastname: Mayer
authors.affiliation: Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.|Städtisches Klinikum Dessau, Klinik für Dermatologie, Venerologie und Allergologie, Immunologie, Wundzentrum, Dessau, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Wild
mesh_terms: D017677:Age Distribution; D058128:Compression Bandages / Q000191:economics / Q000706:statistics & numerical data; D003646:Debridement / Q000191:economics / Q000706:statistics & numerical data; D003879:Dermatologic Agents / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000191:economics / Q000706:statistics & numerical data; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015595:Skin Aging; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*
chemical_list: D003879:Dermatologic Agents
keywords: Chronic wounds; Quality of life; Relapse prevention; Telemedicine; Wound healing
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