5. Is there a difference between wound healing in acute and chronic wounds?

A chronic wound is a wound that takes a prolonged time to heal (Table 2). A wound is considered as chronic after it has lasted for six weeks. The three most common types of chronic wounds are leg ulcers (Figure 4), pressure sores (Figure 5) and foot wounds in diabetic patients, also known as plantar sores (Figure 6) [3]. Caring for such wounds is a major public health issue costing almost € 1 billion each year in France.

Table 2. Differences between acute and chronic wounds.

Figure 4. Leg ulcer.

Figure 5. Necrotic pressure sores of the heel and outer foot.

Figure 6. Foot wound in a diabetic patient.

The most common acute wounds are post-traumatic wounds (dermabrasion, skin tears, cuts and bites), burns and post-operative wounds (Table 2). When they occur in a patient with no risk factors for delayed healing, healing is usually straight forward. The main problem is the aesthetic appearance but also the risk of progression into a pathological (keloid or hypertrophic) scar.

Although the wound-healing phases are identical in all types of wound, the duration of each phase is different, with a longer proliferation and maturation phase in chronic wounds, which is the reason for the very different scar healing process between these two types of wounds.

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