Rethinking Chronic Wound Treatment: Unlocking the Potential of Combination Products for an Unmet Multifactorial Need:...

Area of Science:

• Wound healing research
• Regenerative medicine
• Pharmacology

Background:

• Chronic wounds like diabetic foot ulcers, venous ulcers, and pressure ulcers present a significant clinical challenge due to high prevalence and limited treatment efficacy.
• Current treatments, including medical devices and single pharmacological agents, are insufficient as they fail to address the multifactorial nature of chronic wound chronicity.
• Effective management necessitates simultaneous intervention across all factors contributing to wound chronicity.

Purpose of the Study:

• To propose an integrative therapeutic approach for chronic wounds that targets all relevant pathophysiological mechanisms.
• To review current literature on chronic wound pathophysiology and therapeutic strategies.
• To explore the potential of combination therapies in addressing the limitations of existing treatments.

Main Methods:

• A narrative literature review was conducted, analyzing over 100 peer-reviewed articles.
• Searches were performed in PubMed, Scopus, and Web of Science, supplemented by manual reference screening.
• Included studies focused on mechanisms of wound chronicity and potential therapeutic drugs and biologics.

Main Results:

• Current therapeutic options address only isolated aspects of chronic wound pathophysiology.
• No single agent or device can comprehensively target all relevant mechanisms of chronic wound healing.
• Combining approved drugs and/or biologics may offer synergistic effects, targeting inflammation, infection, angiogenesis, oxidative stress, and tissue remodeling.

Conclusions:

• A topical combination product integrating multiple agents presents a promising strategy to overcome current treatment limitations.
• Advances in understanding wound pathophysiology and available active molecules enable the design of effective, holistic therapies.
• Combination products represent the next generation of chronic wound management, potentially transforming patient outcomes.