Chronic non-healing wounds are estimated to cost the US healthcare $28-$31 billion per
year. Diabetic ulcers, arterial and venous ulcers, and pressure ulcers are some of the most common
types of chronic wounds. The burden of chronic wounds continues to rise due to the current epidemic
of obesity and diabetes and the increase in elderly adults in the population who are more vulnerable to
chronic wounds than younger individuals. This patient population is also highly vulnerable to debilitating
infections caused by opportunistic and multi-drug resistant pathogens. Reduced microcirculation,
decreased availability of cytokines and growth factors that promote wound closure and healing,
and infections by multi-drug resistant and biofilm forming microbes are some of the critical factors
that contribute to the development of chronic non-healing wounds. This review discusses novel approaches
to understand chronic wound pathology and methods to improve chronic wound care, particularly
when chronic wounds are infected by multi-drug resistant, biofilm forming microbes.
Keywords: Chronic wounds, infections, epidemic of obesity, biofilm, cytokines, pathogens.
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