Atypical Wounds

Project period: 2018–2021



Atypical wounds are generally understood as wounds that cannot be defined under one of the primary non healing wound categories, such as venous, arterial, mixed or diabetic foot ulcers. They present a broad spectrum of conditions or diseases caused by inflammation, infection, malignancy, chronic illnesses or genetic disorders. Atypical wounds can be suspected if the wound has an abnormal presentation or location and does not heal with a good treatment plan.


The prevalence of atypical wounds can be as high as 10 % of all wounds, and it is probable that many of these wounds are underdiagnosed. The aim of the document is to bring awareness of the clinical picture, diagnosis and treatment of these wounds. Typical challenges include considerable diagnostic delay and pro-longed healing times, e.g. for the inflammatory and vasculopathy wounds (such as pyoderma gangrenosum, an inflammatory neutrophilic disorder, and cutaneous vasculitis). In addition, many atypical wounds have an enormous impact on the life quality of the affected individuals.

In the years 2018-2021 EWMA has worked on and published a number of resources on atypical wounds, with the objectives to: 

  • Provide an overview about wounds considered atypical, and present the diagnostic criteria, comorbidities and diagnostic tools for these wounds.
  • Present the available treatment options that are best documented. High-quality evidence is sparse, but some retrospective and observational studies as well as randomized prospective studies for pyoderma gangrenosum and vasculitis are available.
  • Present other relevant modern wound healing therapies that are increasingly playing an important role in the management of atypical wounds.


Avaialable ressources

Sponsors of the published materials

The EWMA Document on Atypical Wounds was supported by an unrestricted grant from Essity and PolyMem.

The Atypical Wounds e-elarning modules were supported by an unrestricted grant from Essity.