Chronic wounds are an increasing burden on the health budget. An ageing population, growing rates of diabetes and cardiovascular disease, and increasingly sophisticated wound therapies are creating a surge in healthcare costs. 

While evidence-based practice improves wound care, nurses must navigate the tensions between experience, evidence, expediency and individual patient circumstances. Research into wound healing and failure-to-heal is revealing increasingly complex processes that are affected by both systemic and wound-based factors. It is no longer sufficient to focus exclusively on the physical appearance of the wound itself, without accounting for these other factors. 

Excitingly, there is a growing body of research investigating the differences between adult and fetal healing. Wounds occurring in utero are healed by regeneration, a phenomenon that also occurs in some animals. Adults heal by fibrosis, generating non-functional scars. The future may provide treatments that allow regeneration of injured tissues leading to restored function.

After completing this learning activity and quiz, you should be able to:

• Describe the stages of wound healing and key events within these.
• Outline key molecules involved in healing.
• Describe factors that influence healing.
• Outline the management of bacteria in the wound bed.