Population aging, the surge of chronic diseases, pressures on healthcare budgets, and inequalities in access to care: these global trends converge on a topic that is sometimes overlooked but carries significant clinical and economic consequences—wound treatment and healing. Today, acute wounds (traumatic, post-operative) and especially chronic wounds (diabetic foot ulcers, venous ulcers, pressure sores, inflammatory wounds) represent a growing healthcare burden and a priority for care quality and safety. [1–3]
Chronic Wounds: A Clinical, Human, and Economic Burden
Chronic wounds are typically characterized by slow, incomplete, or recurring healing. They are often accompanied by persistent pain, functional limitations, increased risk of infection, and psychosocial impact (isolation, loss of autonomy). [3]
From a macroeconomic perspective, recent literature confirms a major and sustained financial burden. An analysis published in 2025 in Primary Care highlights the scale and growth of costs in a context of rising comorbidities (diabetes, vascular insufficiency). [1] These dynamics directly impact care pathways: longer hospital stays, readmissions, increased use of devices (dressings, negative pressure therapies), and greater reliance on nursing and specialist care. [1,4]
Diabetes and Diabetic Foot: A Global Accelerator of Wound Risk
Diabetes remains a major driver of the increase in chronic wounds, through neuropathy, microcirculatory disorders, and impaired local defenses. A 2023 meta-analysis estimated a very high global prevalence of “at-risk feet” for ulceration among people with diabetes, highlighting the importance of prevention (screening, therapeutic education, appropriate footwear, podiatric follow-up). [2] Recent studies (2024–2025) continue to document the overall burden of diabetic foot complications (morbidity and mortality, amputations, costs), with significant variations across regions and healthcare access. [5,6]
A Key Global Challenge: Strengthening prevention and early management strategies, as diagnostic delays and interruptions in follow-up quickly lead to severe and costly complications. [2,5,6]
Infections, Biofilms, and Antibiotic Resistance: The “Triad” Complicating Wound Healing
The infectious dimension is central. In many chronic wounds, the presence of biofilms (organized microbial communities) is associated with persistent inflammation and increased treatment resistance, complicating healing. Several recent reviews (2024–2025) highlight the importance of appropriate diagnostic tools and combined approaches (debridement, targeted antiseptics, anti-biofilm strategies) rather than routine use of antibiotics. [7–9]
In parallel, the authors emphasize the need to embed antimicrobial stewardship into wound care practices: accurate infection diagnosis, rational choice of therapy (topical vs. systemic), appropriate duration, and regular evaluation of clinical response. A 2025 review explicitly highlights organizational barriers and concrete levers to improve these practices in clinical settings. [10]
A Key Global Challenge: Treat infections “appropriately,” avoid unnecessary antibiotic use, and reduce the risk of antibiotic resistance while improving healing outcomes. [8–10]
Innovations: Smart Dressings, Sensors, AI, and Remote Monitoring
Innovation in wound care is no longer limited to materials: it now incorporates sensors, data, and remote monitoring.
- Smart Dressings and Sensors: Reviews from 2024 describe the rise of dressings capable of monitoring local parameters (pH, temperature, moisture, exudate) and, in some cases, integrating “active” strategies (conductive hydrogels, controlled release, continuous monitoring). [11,12]
- AI and Prediction: Recent studies connect sensors with AI models to anticipate wound progression and guide clinical decisions (care escalation, suspected infection, protocol adjustment). [11]
- Telehealth / Digital Health: A 2024 meta-analysis (JMIR) evaluated the effectiveness of digital interventions (remote monitoring, apps, tele-expertise) on wound healing outcomes and care pathway organization. Another 2025 review examined the effects of telemedicine on both clinical outcomes and patient-reported outcomes. [13,14]
A Key Global Challenge: Deploy hybrid models (in-person + remote monitoring) to secure care pathways, reduce travel, detect early wound deterioration more effectively, and decrease geographic inequalities in access to expertise. [13,14]
Patient Safety: Preventing Surgical Site Infections
For postoperative wounds, the prevention and monitoring of surgical site infections (SSI) remain a cornerstone of patient safety. Reference documents (WHO, CDC/NHSN) guide practices such as skin preparation, antibiotic prophylaxis, operating environment management, and follow-up. [15,16] Even though not all international recommendations are the latest, they remain foundational and are regularly supplemented with methodological updates and surveillance reports. [16]
Conclusion: A Global Priority at the Intersection of Clinical Care, Economics, and Innovation
Wound treatment and healing encompass highly tangible global challenges: rising comorbidities, infection risk and biofilms, antibiotic resistance, high costs, and inequities in access. Effective responses rely on structured, multidisciplinary care, strengthened prevention (particularly for diabetic patients), infection control protocols, and increasingly, digital tools and “smart” devices that enable more precise and earlier monitoring. [1–14]
Bibliography
- Díaz-Herrera MÁ, et al. The financial burden of chronic wounds in primary care. Primary Care. 2025.
- Maldonado-Valer T, et al. Prevalence of diabetic foot at risk of ulcer development and its… a systematic review and meta-analysis. 2023.
- Human Wound and Its Burden: Updated 2025… SAGE Journals. 2025.
- Burhan A, et al. Effectiveness of negative pressure wound therapy on chronic wounds (systematic review/meta-analysis). 2022.
- Haile KE, et al. Diabetic foot: systematic review and meta-analysis on prevalence… 2025.
- de Souza Santos, G., et al. Global Burden of Diabetic Foot Ulcers: A Systematic Review. 2025. (Review; cross-reference with major indexed sources according to editorial standards)
- Liu Y, et al. Biofilm therapy for chronic wounds. International Wound Journal. 2024.
- Shen AZ, et al. Biofilms and Chronic Wounds: Pathogenesis and Treatment Strategies. 2025.
- Almuhanna Y, et al. Microbial Biofilms as Barriers to Chronic Wound Healing. J Clin Med. 2025.
- Blackburn J, et al. Applying Antimicrobial Strategies in Wound Care Practice (antimicrobial stewardship). 2025.
- Prakashan D, et al. Smart sensors and wound dressings: Artificial intelligence… 2024.
- Fang Y, et al. Intelligent dressings… conductive hydrogels… monitoring and healing. 2024.
- Bai X, et al. Digital Health Interventions for Chronic Wound Management: systematic review and meta-analysis. JMIR. 2024.
- Zhang X, et al. Effectiveness of Telemedicine on Wound-Related Outcomes: systematic review and meta-analysis. 2025.
- OMS. Global guidelines for the prevention of surgical site infection. 2018.
- CDC/NHSN. Surgical Site Infection Event (SSI) – NHSN Manual (current). Jan 2026.