Wound care is a complex practice at the crossroads of multiple disciplines: dermatology, surgery, vascular medicine, diabetology, geriatrics, nursing, podiatry, and physiotherapy. This field, faced with population aging and the rise of chronic diseases, now represents a major public health challenge.
As a fundamental principle aptly states: “We do not treat a wound, but a patient who has a wound.” This holistic approach highlights the complexity of wound healing, which depends on multiple factors related to the patient’s overall condition.
A Major Public Health Challenge
The figures speak for themselves:
| Indicator | Data |
| People Living with Wounds in France | 2.5 million |
| Chronic wounds | 1.2 million |
| Population with leg ulcers | 0,8 % |
| Hospital beds occupied due to pressure ulcers | 8 % |
| Diabetic patients with foot wounds | 200 000 |
| Annual cost of care | €1.5 billion |
Technological Innovations
Increasingly Sophisticated Dressings
Since the 1960s, research has shown that wounds heal more quickly in a moist, occlusive environment. This discovery revolutionized dressing design, which can now absorb excess exudate, provide moisture to dry wounds, promote hemostasis, and reduce pain and the risk of infection.
Current product ranges include foam dressings, hydrocolloids, hydrofibers, hydrogels, and alginates. Some incorporate active substances to relieve pain or restart stalled healing. Smart dressings equipped with sensors to measure wound pH or moisture levels are also under development.
The Fight Against Biofilms
Research has revealed that 23% to 80% of chronic wounds harbor a biofilm on their surface. These communities of microorganisms form a protective matrix that promotes bacterial proliferation while resisting antiseptics. The recommended strategy combines thorough cleansing, debridement, and the application of appropriate dressings, such as irrigation-absorbing dressings.
Future Directions
Several promising avenues are being explored: culturing fibroblasts and keratinocytes to create cellularized skin substitutes, laser phototherapy activating chromophores, 3D bioprinting of artificial skin, and even the use of fish skin or porcine intestinal submucosa.
Toward Better Organization of Care
The Rise of Tele-Expertise
The Domoplaies program in Occitanie illustrates the benefits of telemedicine: patients at home or in nursing homes (EHPADs) can be connected within less than 48 hours to a wound care specialist. Around 70 experts take part in this protocol, supporting between 3,000 and 3,500 patients. The results are remarkable: €10,000 in savings and a 164-day reduction in healing time per patient.
The Nursing Act of June 2025
The law of June 27, 2025 paves the way for greater autonomy for nurses, allowing direct patient access for an assessment of wound severity. It also provides for a mandatory 24-hour training program on wound care for nurses, significantly enhancing their skills in this area.
The Patient Perspective
The testimony of Éléonore Piot de Villars, a patient expert living with chronic sequelae following cancer, illustrates the daily reality of people living with chronic wounds. She emphasizes the importance of collaboration between patients, healthcare professionals, and industry, as well as the “invisible work of patients”: skin hygiene, monitoring of at-risk areas, regular dressing changes, physiotherapy sessions, and more.
Trust with home-care nurses is essential, as is continuity of care between hospital and community settings. Modern medical devices, more technical and user-friendly, help improve patients’ quality of life.
Conclusion
The wound care and healing sector is at a turning point. Although innovation remains largely incremental rather than disruptive, technological advances (smart dressings, skin substitutes, telemedicine), combined with organizational changes (expanded nursing competencies, improved hospital–community coordination), are shaping a promising future for patient care.
Many challenges remain: maintaining access to innovation despite budgetary constraints, strengthening the training of healthcare professionals, and developing early diagnostic tools—particularly for the detection of biofilms and infections. Collaboration between industry, healthcare professionals, and patients remains the key to continuously improving care.
Source: Snitem Info #239 – Fall 2025