Essential Strategies for Diagnosing and Treating Chronic Ulcers Linked to Comorbidities: Hadar Avihai Lev-Tov, MD

Hadar Avihai Lev-Tov, MD, associate professor of clinical dermatology and cutaneous surgery at the University of Miami Health System, emphasizes a holistic approach to wound care, especially for patients with comorbidities like diabetes or peripheral vascular disease.

He stresses that a chronic, nonhealing ulcer is often a symptom of an underlying systemic issue, not just a localized problem. By considering what might be "missing" in the patient's overall health, dermatologists can make accurate diagnoses and initiate appropriate treatments that, in some cases, can be life-saving. This perspective highlights the critical need for comprehensive patient assessment in wound management to ensure effective healing and improved patient outcomes.

This transcript was lightly edited; captions were auto-generated.

Transcript

How do you approach managing wound care for patients with comorbidities to ensure comprehensive care?

We like to say in wound care that you have to remember that there's a patient around the hole in the patient. Besides the wound, the wound is actually telling you something else is going on on the inside, and that's true for a lot of dermatology, but especially in wounds.

If you are encountering a chronic ulcer that is not healing, you have to remember that it came from somewhere. Something is wrong with the patient, and the most common things that we see are chronic venous insufficiency or diabetes, but there are other rare conditions that may be even life-threatening that you can save a life. When you see a chronic wound and you're unsure what is happening, you have to always consider, what am I missing? What is happening under the skin that can make this wound happen? Then you can really make a good diagnosis and start the right treatment that can sometimes even save a life.