Chronic nonhealing wounds area unit draining with high morbidity and mortality during an extremely vulnerable patient population. Despite intensive efforts to develop therapeutic ways for the effective treatment of chronic wounds, so far, restricted clinical success has been achieved. the explanations for the restricted clinical success embrace (i) the absence of valid centers of excellence, education, and standards in wound care management; (ii) restricted numbers of funding agencies with a central concentration on chronic wounds; (iii) lack of strong proof for wound healing approaches within the current literature beside the shortage of methodologic consistency in clinical trials; (iv) quality of wound setting thanks to patients’ comorbidity; (v) lack of transparency in politics as well as the quality of the compensation procedures; (vi) growing quality with the increasing share of aging populations; and (vii) jammed market with overwhelming “me too” product with restricted clinical efficacies. this angle is meant to debate these challenges within the field of wound care at Chronic wounds in Abu Dhabi and introduce multidisciplinary opportunities for substantial improvement of wound healing management. to deal with these challenges within the field, we recommend that stakeholders in wound care adopt a proactive integrated response that utilizes a broad network and takes full advantage of rising technologies.

Keywords: chronic nonhealing wounds, infection, comorbidity, obesity, stakeholders

Introduction Chronic wounds area unit typically cited as wounds that fail to heal through the body’s natural healing method (roughly but half-hour wound closure in four weeks when treatment).1–4 many vital parameters, as well as anatomical location of the injuries and complications caused by coincidental diseases that the patients could have, affects the quality of chronic wounds.5 a number of the causalities in the creation of chronic wounds area unit, however not restricted to: poor circulation, uncommon native pressure to the wound web site, the existence of pathology that causes loss of protecting sensation, risk of infection, unresolved inflammation, and different severe impaired healing processes like lack of growth, animal tissue migration, and cell proliferation.5–10 The impact of those issues on chronic wounds is heightened by having advanced diseases out of management, as an example, by aldohexose accumulation within the wound website.11

All of those advanced problems limit the success in wound management that, in turn, negatively affects the standard of lifetime of the patients and induces large prices to the world healthcare systems.12–15 The quality of the wound care system could worsen within the close to future thanks to (i) increasing prices of wound care; (ii) the Associate in Nursing aging population; (iii) increasing prevalence of comorbidities (eg, obesity); and (iv) microorganism resistance to antimicrobials.5 prognosticative approaches demonstrate that the prevalence of advanced diseases (eg, diabetes, cardiopathy, and neurodegenerative disorders) can considerably increase over subsequent few decades. additionally, fashionable medication has extended our generation which suggests that age, as another advanced parameter, can play a vital role in worsening the quality of chronic wounds. Therefore, it's crucial that we tend to act currently with a proactive and innovative approach to revolutionize the manner in wounds area unit treated. If we tend to don't, we tend to risk future generations’ judgment of America on what proportion we tend to knew and what we tend to may have done.

To revolutionize this wound management practices, we tend to 1st have to be compelled to completely determine and perceive the issues from the views of all key stakeholders as well as patients and caregivers, clinicians (with all connected specialties), nurses, engineers (with all connected expertise), decision-makers (eg, in hospitals, biotechnology corporations, and insurance companies), influencers, and saboteurs. Once the issues area unit well established, we are going to be able to propose ways to beat the problems.

In this perspective, we tend to determine and introduce these issues/barriers with the chronic wound system (ie, interaction of all concerned stakeholders and their entire efficiency) that area unit limiting clinical success. To do this, additionally to our own data and experiences, we tend to gather viewpoints of consultants from numerous stakeholders declared higher than. we tend to additionally propose ways for methods to use this data as a singular chance to materially improve the standard and success rate of wound healing management.

The Core drawback Almost all these problems concerning chronic wounds stem from a core strategic problem: wounds aren't thought about as Associated in Nursing actual sickness. this implies that patients with chronic wounds area unit being treated by a large kind of clinicians and nurses supported their expertise and views on the treatment ways, which might take issue considerably from one setting and region to a different.16

The fact that wounds aren't viewed as a sickness entity sets the stage for the main problems we tend to face within the current wound care system as well as, however not restricted to: (i) lack of hardiness and reliableness in each clinical and analysis outcomes that causes misunderstanding of the wound healing knowledge and limits meta-analysis; (ii) a poor understanding of the wound setting and therefore the corresponding biomolecular signals (eg, through exudates); (iii) reliance on out-of-date systems/tools to categorize/measure numerous sorts of wounds; (iv) restricted integrated functioning between stakeholders; and (v) the jammed, inefficient market with an awesome range of comparable product. Therefore, one among the central queries that must be properly answered is that of “who ought to treat chronic wounds”? the primary step for addressing this question and therefore the associated problems is to focus on the core drawback by recognizing “chronic wound” as a sickness. this may need involvement of key decision-makers and legislators to make a transparent, comprehensive, and thoughtful strategic set up for the wound care system (similar to what has been in dire straits different severe conditions as well as cancer, vessel and neurodegenerative diseases).