Portail Guide

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.


1. Singer AJ, Clark RA. Cutaneous wound healing. N Engl J Med 1999;341: 738-46.

2. Eming SA, Krieg T, Davidson JM. Inflammation in wound repair: molecular and cellular mechanisms. J Invest Dermatol2007; 127: 514-25.

3. Suivi en ville des plaies chroniques : ulcère veineux de jambe, escarre, plaie du pied diabétique. Assurance maladie, octobre 2015.

4. Plaies aiguës en structure d’urgence. Référentiel de bonnes pratiques. SFMU, 2017: 32 p.

5. Sgonc R, Gruber J. Age-related aspects of cutaneous wound hea- ling: a mini-review. Gerontology 2013; 59: 159-64.

6. Majtan J. Honey: an immunomodulator in wound healing. Wound Repair Regen 2014; 22: 187-92.

7. Opletalová K, BlaizotX, Mourgeon B, et al. Maggot therapyfor wound debridement: a randomized multicenter trial. Arch Dermatol 2012; 148: 432-8.

8. van den Broek LJ, Limandjaja GC, Niessen FB, Gibbs S. Human hypertrophic and keloid scar models: principles, limitations and future challenges from a tissueengineering perspective. ExpDer- matol 2014; 23: 382-6.

9. Prise en charge de l’ulcère de jambe à prédominance veineuse hors pansement. Recommandations HAS, 2006.

10. La compression médicale dans les affections veineuses chroniques. Fiche de bon usage HAS, 2010.

11. Edmonds M, Lázaro-Martínez JL, Alfayate-García JM, et al. Sucrose octasulfate dressing versus control dressing in patients with neu- roischaemic diabetic foot ulcers (Explorer): an international, multi- centre, double-blind, randomised, controlled trial [published correction appears in Lancet Diabetes Endocrinol 2018]. Lancet Diabetes Endocrinol 2018; 6: 186-96.

12. Reinholz M, Poetschke J, Schwaiger H, Epple A, Ruzicka T, Gauglitz GG. The dermatology life quality index as a means to assess life quality in patients with different scar types. J Eur Acad Dermatol Venereol2015; 29: 2112-9.

<< 4. What is the impact of topical corticosteroids on wound healing? >> 6. How should you clean wounds?
© John Libbey Eurotext, 2021 This work may not be reproduced in whole or in part without the permission of the publisher or the Centre Francois d’Exploitation du Droit de Copie (CFC), 20, rue des Grands-Augustins, 75006 Paris, France.

With the institutional support of the laboratories