Chronic Wound Pathophysiology, Advanced Diagnostic Modalities, and Therapeutic Strategies: The Role of Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT) in Prognostic Assessment

Chronic wounds represent a complex and multifactorial medical challenge, often associated with underlying vascular insufficiency, metabolic disorders, or persistent inflammatory states. The management of these lesions necessitates a comprehensive diagnostic approach to evaluate tissue perfusion, microvascular integrity, and structural abnormalities. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have emerged as pivotal imaging modalities in the assessment of chronic wounds, providing high-resolution, cross-sectional visualization of vascular and dermal pathology. This article explores the etiopathogenesis of chronic wounds, discusses contemporary treatment paradigms, and evaluates the prognostic implications of IVUS and OCT in guiding therapeutic decision-making. By integrating advanced imaging techniques with evidence-based wound care protocols, clinicians can optimize healing outcomes and mitigate long-term complications in high-risk patient populations.