Wounds encompass a broad and clinically diverse spectrum of skin injuries; from the precisely made incisions of dermatologic procedures to persistent, non-healing lesions. In the context of dermatology, wounds can be organized into two broad categories: acute wounds, which result from a defined event and are expected to heal in an orderly, timely fashion; and chronic wounds, which stall in the healing process and fail to resolve despite standard care.1,2,3
Acute dermatologic wounds include surgical sites such as those following Mohs micrographic surgery for skin cancer, shave biopsies, and cryotherapy lesions, as well as dermal donor and graft sites, minor abrasions, first- and second-degree burns, sunburns, and radiation dermatitis in patients undergoing cancer treatment.
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Chronic wounds represent a more severe end of the spectrum and include full-thickness wounds, pressure sores (also called pressure ulcers or bedsores), and dermal ulcers such as lower leg and venous ulcers. These conditions are most commonly seen in elderly, diabetic, or immobile patients whose underlying health status impairs the skin's natural capacity to repair itself.
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Regardless of type or cause, all wounds go through the same basic healing process made up of four stages: stopping the bleeding (hemostasis), inflammation, new tissue growth (proliferation), and tissue strengthening and repair (remodeling). In acute wounds, this process follows a clear and orderly path. Blood clotting stops the bleeding, immune cells remove bacteria and debris, new tissue forms to close the wound, and collagen is produced to restore strength and structure. In chronic wounds, this process does not work as expected. Healing often becomes stuck in the inflammation stage. This can be caused by factors such as bacterial buildup, high levels of enzymes that break down tissue, and ongoing inflammatory signals that prevent healing from progressing. Additional factors such as poor circulation, diabetes, weakened immune function, radiation damage, or repeated pressure on the skin (as seen in pressure sores) can further interfere with the body’s ability to heal properly.
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