Healing Chronic Wounds: Current Challenges and Potential Solutions

Abstract

Purpose of Review: The purpose of this review is to raise awareness, examine the challenges faced by wound care researchers and explore opportunities for potential improvements. Recent findings: Chronic wounds are associated with significant morbidity and mortality, and they represent a major medical and financial burden. Despite this, no new therapy has received FDA efficacy approval for the treatment of chronic wounds since 1997. Previous preclinical studies using animal models did not translate to human wounds due to inherent limitations of experimental models, variability in assessment methods and overall experimental design. Clinical trials continued to be challenged by the balance of the inclusion and exclusion criteria, the high cost and time expenditure of the trials, and the constraint of a single FDA-acceptable outcome of complete wound closure. Summary: Wound research faces multiple challenges in both pre-clinical and clinical research that slowed progress and development of efficacious therapies. Solutions to such challenges will provide new opportunities for improved study design in the future.

Mevastatin promotes healing by targeting caveolin-1 to restore EGFR signaling

“…Chronic DFUs are a serious life-threatening disease; they are rapidly increasing in incidence and often result in lower limb amputation and a shortened life span (2,(22)(23)(24). To date, treatments for DFUs remain limited and achieve modest efficacy in restoring healing (1).…”

Skin wound healing assisted by angiogenic targeted tissue engineering: A comprehensive review of bioengineered approaches

“…Such wounds usually exhibit some common features including constant or protracted inflammation, persistent edema and infections which result in formation of microbial biofilm and consequently tissue necrosis due to antimicrobial drug‐resistance (Figure 2, chronic) 37,38,40 …”

Topical L‐thyroxine: The Cinderella among hormones waiting to dance on the floor of dermatological therapy?

“…167,168 Given hypothyroidism-associated WH abnormalities, 7,160 direct evidence that topical T3 and T4 promotes acute WH in mice in vivo 93 and that T4 promotes epidermal repair and possibly even angiogenesis in wounded human skin ex vivo, 151 171 should also facilitate WH under the severely hypoxic conditions that characterize most skin ulcers. [172][173][174] We therefore advocate to rigorously explore whether topical T4…”