Chronic wound

A chronic wound is a wound that does not progress through the normal stages of wound healing—haemostasis, inflammation, proliferation, and remodeling—in a predictable and timely manner. Typically, wounds that do not heal within three months are classified as chronic. Chronic wounds may remain in the inflammatory phase due to factors like infection or bacterial burden, ischaemia, presence of necrotic tissue, improper moisture balance of wound site, or underlying diseases such as diabetes mellitus.

In acute wounds, a regulated balance of pro-inflammatory cytokines (signalling molecules) and proteases (enzymes) prevent the degradation of the extracellular matrix (ECM) and collagen to ensure proper wound healing.

In chronic wounds, there is excessive levels of inflammatory cytokines and proteases, leading to excessive degradation of the ECM and collagen. This disrupts tissue repair and impedes recovery, keeping the wound in a non-healing state.

Chronic wounds may take years to heal or, in some cases, may never heal, causing significant physical and emotional stress for patients and placing a financial burden on healthcare systems. Acute and chronic wounds are part of a spectrum, with chronic wounds requiring prolonged and complex care compared to acute wounds.