When healing stops…

Abstract

The non-healing wound is encountered by practitioners in multiple clinical situations. It is characterised by a stalled process in the healing trajectory. The non-healing wound is not necessarily a chronic wound, although the two conditions have many similarities. With the advent of improved molecular biological understanding, many cellular events can be recognised as patterns for non-healing, and possible interventions may become evident. Thus, once obvious host disease problems have been excluded, exaggerated inflammation with high matrix metalloproteinase levels and the presence of biofilm are causative factors in many cases of non-healing wounds. Intervention may range from a simple change of dressing type and debridement to more sophisticated wound bed interventions. A systematic approach to the non-healing wound is presented.