The Chronic Wound Syndrome: A New Approach to Understanding the Pathophysiology and Management of Chronic Wounds
10.22467/jwmr.2025.03251
- Author:
Wolmark XIQUES-MOLINA
;
José Javier Arango ÁLVAREZ
;
Juan Manuel Salcedo DÍAZ
;
Gloria Alexis Triviño BARRAGÁN
;
Rodrigo Triana RICCI
;
Alejandro Molina HERNÁNDEZ
;
Ornella FIORILLO-MORENO
;
Johana GALVÁN-BARRIOS
;
Patricia DELGADO
;
Ivan David LOZADA-MARTINEZ
- Publication Type:Review Article
- From:
Journal of Wound Management and Research
2026;22(1):3-13
- CountryRepublic of Korea
- Language:English
-
Abstract:
Chronic wounds have traditionally been classified based on their etiology (venous ulcers, diabetic ulcers, pressure ulcers, etc.), reinforcing a reductionist perspective of the problem. However, this fragmented model has undermined understanding of their common pathophysiology and standardizing management approaches. From a medical epistemology standpoint, the evolution of pathological concepts has demonstrated that many syndromes were initially considered heterogeneous disorders until their underlying commonality became evident (e.g., metabolic syndrome, systemic inflammatory response syndrome). This review discusses and supports the proposition that chronic wounds should be conceptualized within a syndromic framework, wherein a shared set of pathophysiological processes underlies their diverse clinical manifestations, prompting a move beyond etiological reductionism. This proposition is supported by three epistemological arguments: biological, clinical, and practical. Through an analysis of fundamental syndromic principles, relevant examples illustrate this novel perspective. Ultimately, this proposition aims to advance a comprehensive and multi-level approach to chronic wound care, emphasizing multidimensional therapies that facilitate optimal, timely, and cost-effective outcomes. Such a conceptual shift would enable the integration of therapeutic strategies, the development of cross-cutting biomarkers, improved prediction of treatment responses, and greater consensus in research.
