This book describes how chronic wounds follow a completely different healing trajectory to acute wounds and discusses the factors associated with these poor healing trajectories. These factors include age, chronic inflammation, phenotypic changes in such cells as macrophages, fibroblasts, and keratinocytes, colder, alkaline wound milieu, wound related hypoxemia, and diabetes. Other factors implicated include reperfusion injury, poor patient compliance, presence of undiagnosed and therefore unmanaged biofilms and wound pain.