Advances in understanding and management of chronic wounds: translational medicine approaches

Chronic wounds represent a global health challenge, affecting millions of patients and resulting in substantial morbidity, mortality, and economic burden. Great advances are being made in understanding the basic molecular and cellular mechanisms that maintain wounds in a chronic state. Despite these developments, no new pharmacological treatments have been approved for over two decades. This lack of progress reflects limitations in preclinical models, stringent regulatory requirements, and patient heterogeneity. The diverse patient population is characterized by multiple comorbidities and wounds of multifactorial origin, which complicates diagnosis and hinders the development of effective therapies. Focusing on human studies and translational models, this review provides an overview of the biology of chronic wounds, current treatment options, and recent developments. Emerging translational strategies are shifting the paradigm from passive management with traditional wound dressings to personalized, multimodal interventions, as well as advances in biomarker identification, including omics- and cell-based functional biomarkers. Combined with artificial intelligence, these innovations hold the potential to initiate a new era of precision medicine for chronic wound care.