Wound Care Research: How We Get to the New and Newsworthy

Wound care research has been quite busy over the past few years. Once an area often overlooked by pharma, recent years have seen tremendous growth in cutting-edge research. From investigating molecular pathways to exploring the role of AI to finding ways to target diseases that ravage underserved populations, researchers are constantly seeking ways to push the boundaries of what is possible in wound care and treatment.

So, what’s in the works? What’s succeeding and how does it work? Exploring the world of wound care research begins with understanding its early history, how research functions, and looking at some of the more promising research projects underway and on the horizon.

Research Methods in Wound Care

Clinical research in wound care is relatively new compared to other medical fields. Traditionally, pharmaceutical companies and researchers have viewed wound care as a difficult field to target with research and investment. Patients are frequently older, often live in underserved communities, and may have multiple, complex wounds that need different treatments over longer periods of time, often by various healthcare providers. In other words, these patients are not the easiest to reach and don’t necessarily make the best candidates for repeatable research, given the complications that multiple wounds may pose.

Additionally, some patients may have difficulty traveling to and from testing and monitoring sites or complying with study requirements. But the need for new treatments is dramatic and growing.  Research on the social and economic burden indicates that chronic wounds affect 10.5 million Medicare recipients.  Also, a recent report suggests that the global wound care market, valued at $21.11 billion in 2024, is expected to climb to $30.27 billion by 2031.

Continued growth in wound care clinical research is vital to finding better therapies, particularly with greater emphasis on patient-centric research methodologies.  New healing treatments such as advanced dressings, negative pressure therapies, and biological agents are being tested as research moves to clinical trials.  Clinicaltrials.gov, a great resource to find out what research is currently underway and its subject,  lists more than 1,400 wound care studies in various stages of recruitment, execution, completion, and termination.  This body of work generates the all-important data companies need to document the safety and effectiveness of innovations, which they may submit to regulatory agencies for review.  If approved, these new therapies will eventually reach clinical practice.  

What are some of the major categories of wound care research?  There are several looking into various areas of innovation. Here are some of the more common types of study in wound care research right now.

• Laboratory research, known as in vitro studies, allows scientists to study wound healing at the cellular level. By developing models that researchers can use to analyze how cells might respond to treatments, they gain insight into which approaches might be considered promising for further study.
• Advanced imaging technologies such as 3D imaging, thermography, and fluorescence photography have become more common, offering precise insights into the wound environment. These technologies, combined with data analytics and machine learning models, are shaping the future of wound care by making personalized treatment more achievable.
• As of September 2024, about three dozen studies are in progress focused on non-healing wound care. These cover a range of wound challenges, including diabetic foot ulcers and venous leg ulcers.
• Systematic reviews and meta-analyses of existing studies provide meaningful overviews of what works best across different patient populations.

Diabetic Foot Ulcers: A Major Challenge in Wound Care

One of the areas in wound care most in need of new therapies, approaches to treatment, and funding for research is diabetic foot ulcers (DFUs).  Clinicaltrials.gov lists more than 600 DFU studies in various recruitment stages or are active or completed.

These ulcers are devastating to patients when left un- or under-treated, as they not only severely affect a patient’s quality of life, but can also lead to amputations and death. Providers can also face challenges when treating DFUs, as poor responses can in turn lead to negative quality ratings and affect reimbursement. Despite advancements in wound management, DFUs are notoriously difficult to heal due to the chronic nature of diabetes, impaired healing mechanisms, and frequent infections, not to mention difficulty with early detection and historical lack of investment in research and treatment.

What can help reduce the impacts of this complex condition? Research—specifically understanding the biological processes that impede healing. Recent research has shown that analyzing metabolites in DFU exudates can offer valuable insights into the wound’s molecular environment. Metabolites are “small molecules that are intermediates or products of metabolism, many of which are freely filtered by the kidneys.” By profiling these metabolites, researchers hope to uncover biomarkers indicating how well a wound is healing or at risk of infection.

A recent systematic review and meta-analysis of 17 randomized clinical trials found that higher levels of metformin, a common diabetes medication, in the exudates of DFU patients may correlate with better healing outcomes. This discovery suggests that specific drug combinations, like metformin with insulin, could improve treatment responses and reduce the likelihood of amputation. However, further studies are needed to understand the underlying mechanisms driving these effects and how they might be optimized in clinical practice.

Future research into the metabolic profiles of DFU patients, and other factors involved in diagnosing and treating DFUs, could provide even more precise treatment options, tailoring interventions to the individual’s metabolic needs. By correlating metabolic profiles with clinical outcomes, researchers may be able to predict which patients are at greater risk of slow healing or infection, allowing clinicians to adjust treatments proactively.

Other Major Areas of Ongoing Research

The field of wound care is currently seeing significant advances in several key areas, each looking to improve healing times and patient outcomes. One of the most exciting developments is the creation of skin substitutes and biomaterials. These innovations are designed to replicate the structure and function of natural skin, providing temporary or permanent coverage for wounds while stimulating the body to regenerate its own tissue. These are promising, but these innovations are also costly, so wound care researchers’ focus is finding ways to make these and other products more cost-effective.

Stem Cell Therapy

Another area that holds tremendous promise is in stem cell therapy. Researchers are particularly interested in the potential of mesenchymal stem cells (MSCs) to accelerate healing by differentiating into skin cells and promoting new blood vessel formation. By secreting growth factors that aid in tissue regeneration, MSCs could offer a solution for patients with chronic wounds that are slow to heal. Some clinical trials have already shown encouraging results, but further research is needed to optimize stem cell therapies for widespread use.  The good news is, there are currently several dozen wound studies underway using MSCs.

Negative pressure wound therapy

Negative pressure wound therapy (NPWT) has been a mainstay of wound care therapy for nearly 50 years. What’s new now? Researchers are examining how this technique can be combined with other treatments to improve outcomes. NPWT uses controlled suction to promote wound healing. Researchers are now looking into how the technology can be enhanced to deliver medications or other therapeutic agents directly to the wound bed.

Wound Microbiome

The woundmicrobiome is also a growing area of interest in research. Traditional approaches to wound care have focused on eradicating harmful bacteria to prevent infection, but today’s research suggests that a healthy balance of microorganisms in the wound environment may actually help promote healing. Scientists are studying how to manipulate the microbiome with antimicrobial agents, probiotics, and other interventions to create an optimal environment for wound repair.

AI Changing Research Landscape

At the same time, AI and predictive analytics are transforming how clinicians approach wound care. By analyzing data from electronic health records, wound images, and even wearable sensors, AI algorithms can predict which wounds are likely to become problematic and guide more targeted treatment plans. Plus, AI-powered digital wound care platforms enable researchers to better monitor and engage with patients remotely, with some even allowing patients to send images of their wound’s progress directly to researchers. Cutting-edge AI tools are helping to make personalized wound care a reality, allowing clinicians to tailor interventions to each patient’s specific risk factors and wound characteristics.

Looking Forward: Emerging Trends in Wound Care Research

What can we expect in the future from wound care research? Luckily, quite a bit.  The future of wound care research is filled with exciting advances, especially with the growth in personalized medicine. As researchers gather more data on how wounds heal and how patients respond to different treatments, the potential for developing individualized treatment plans via mobile apps, wearable smart bandages, and wound dressings becomes more tangible.

Smart wound dressings, for example, could monitor the condition of the patient’s wound in real time and deliver medications as needed.  They could also track factors such as moisture, temperature, and pH levels, which would then send data directly to healthcare providers, enabling immediate intervention if signs of infection or other complications are detected.

3D printing and biofabrication are also poised to revolutionize wound care. Scientists are already working on printing customized skin grafts and wound dressings that are tailored to fit individual patients. In the future, biofabrication could make it possible to mass-produce skin substitutes, making these treatments more available to a broader range of patients. It’s like real like science fiction, coming our way.

The field of gene therapy is also generating lots of exciting innovations. How does it work? Gene therapy offers the potential to manipulate the body’s own cells to enhance wound healing.  Gene therapy in wound care involves using genetic material to promote healing by correcting or replacing defective genes responsible for wound healing processes.  It has been shown to enhance angiogenesis in chronic wounds, which aids in the  formation of new blood vessels from pre-existing ones so wounded tissue can receive more oxygen and nutrients during the healing process. 

Wound Care’s Wide-Open Future

Wound care research is moving forward quickly, bringing new hope to patients with chronic wounds and tough-to-treat conditions, such as diabetic foot ulcers and pressure injuries. Innovations like skin substitutes, stem cell therapy, AI-powered analytics, and personalized medicine are in various stages of development. The future of wound care looks encouraging with these treatments, which may prove to be more precise and effective.

While challenges remain, especially in managing diabetic wounds, ongoing research is leading to innovative solutions that could significantly improve patient outcomes and ease the physical, emotional, and financial burden of wound care. As we continue to explore new technologies and improve existing therapies, the potential to transform wound healing has never been more promising.