Chronic wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers, are a major challenge in wound care, consuming significant healthcare resources globally. These wounds fail to progress through the normal healing phases and often recur, leading to functional loss, decreased quality of life, and high treatment costs. Chronic wounds are associated with factors like prolonged inflammation, persistent infections, and dysfunctional cells, which hinder healing. Understanding the underlying pathophysiology and managing these factors is crucial for successful treatment. Chronic wounds can be classified into vascular, diabetic, and pressure ulcers, each with distinct underlying pathologies. The healing process involves four phases: hemostasis, inflammation, proliferation, and remodeling. Chronic wounds often stall in the inflammation phase, leading to prolonged inflammation, excessive proteases, and senescent cells. These factors disrupt the healing process and require targeted interventions. Effective treatment of chronic wounds requires a comprehensive approach, including patient and wound assessment, addressing underlying conditions, and using advanced therapies. Proper wound bed preparation, debridement, and offloading are essential. Advanced therapies such as negative pressure wound therapy (NPWT), hyperbaric oxygen therapy (HBOT), and biophysical modalities like electrical stimulation and ultrasound are used to promote healing. However, the efficacy of these therapies is often not well-supported by evidence, and their use should be based on individual patient needs. The management of chronic wounds involves a multidisciplinary approach, with a focus on vascular and infectious factors. Wound assessment is critical to determine the underlying causes and guide treatment. Advanced wound care technologies, including growth factors, extracellular matrices, and engineered skin, are used to enhance healing. However, the selection of appropriate therapies is often not evidence-based, and further research is needed to improve treatment outcomes. In summary, chronic wounds require a systematic and evidence-based approach to address their complex pathophysiology and underlying causes. Effective treatment involves a combination of standard wound care, advanced therapies, and patient-specific interventions to promote healing and improve quality of life.Chronic wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers, are a major challenge in wound care, consuming significant healthcare resources globally. These wounds fail to progress through the normal healing phases and often recur, leading to functional loss, decreased quality of life, and high treatment costs. Chronic wounds are associated with factors like prolonged inflammation, persistent infections, and dysfunctional cells, which hinder healing. Understanding the underlying pathophysiology and managing these factors is crucial for successful treatment. Chronic wounds can be classified into vascular, diabetic, and pressure ulcers, each with distinct underlying pathologies. The healing process involves four phases: hemostasis, inflammation, proliferation, and remodeling. Chronic wounds often stall in the inflammation phase, leading to prolonged inflammation, excessive proteases, and senescent cells. These factors disrupt the healing process and require targeted interventions. Effective treatment of chronic wounds requires a comprehensive approach, including patient and wound assessment, addressing underlying conditions, and using advanced therapies. Proper wound bed preparation, debridement, and offloading are essential. Advanced therapies such as negative pressure wound therapy (NPWT), hyperbaric oxygen therapy (HBOT), and biophysical modalities like electrical stimulation and ultrasound are used to promote healing. However, the efficacy of these therapies is often not well-supported by evidence, and their use should be based on individual patient needs. The management of chronic wounds involves a multidisciplinary approach, with a focus on vascular and infectious factors. Wound assessment is critical to determine the underlying causes and guide treatment. Advanced wound care technologies, including growth factors, extracellular matrices, and engineered skin, are used to enhance healing. However, the selection of appropriate therapies is often not evidence-based, and further research is needed to improve treatment outcomes. In summary, chronic wounds require a systematic and evidence-based approach to address their complex pathophysiology and underlying causes. Effective treatment involves a combination of standard wound care, advanced therapies, and patient-specific interventions to promote healing and improve quality of life.