Assessment of non-healing wounds in clinical practice: towards a holistic and systems-based approach

Non-healing wounds remain a persistent and costly challenge within UK healthcare. These wounds, which fail to follow a timely and orderly healing process, are frequently linked to systemic comorbidities, delayed assessment and fragmented care. This article explores the underlying pathophysiology of non-healing wounds and provides an evidence-informed overview of their assessment and management. Drawing on current guidance and clinical literature, the article examines the importance of holistic patient evaluation, accurate diagnosis and systems-based understanding of delayed wound healing. Factors such as age, comorbidity, lifestyle, medication and psychosocial context are discussed alongside the clinical characteristics of the wound itself. The role of timely diagnostic investigations and appropriate dressing selection is also considered. Emphasis is placed on improving assessment standards and promoting structured clinical reasoning to support recovery, prevent complications and reduce the burden on services. A comprehensive, person-centred approach is essential to improving outcomes in patients with complex wounds.