Any wound (abrasions, lacerations, incisions, puncture wounds, burns) is initially considered an acute wound, as long as is it follows the expected stages of healing. In the absence of significant evidence of healing within about four weeks, the wound has likely entered the chronic stage.

The most common form of chronic wounds are ulcers of the lower extremities: around 0.6-3% of people aged > 60 years and 5% of the > 80-year-olds are affected. In the course of a lifetime, almost 10% of the population will develop a chronic wound, with a wound-related mortality rate of 2.5%. In the US, the annual costs of chronic wounds is estimated at around 30 billion $US^.2,3

The short answer is: no, not really. The longer answer is: it’s complicated, and ultimately it does not matter, given the evidence-based assumptions that can be made about biofilm. Some clinicians promote what they believe are ‘clinical cues’ of biofilm presence, using naked-eye observations including a ‘shiny’, ‘translucent’, ‘slimy’ layer on the non-healing wound surface. However, although it is arguable that these ‘signs’ may represent manifestations of the presence of biofilm, biofilm itself cannot in fact be seen with the naked eye. The new “World Union of Wound Healing  Societies” position statement notes that ‘all non-healing chronic wounds potentially harbor biofilms’ and, therefore, relying on anecdotal visual cues is unnecessary. Clinicians should assume that ‘all non-healing, chronic wounds that have failed to respond to standard care have biofilm’. Consequently, all treatments should be targeted towards effective disruption of biofilms and prevention of their formation and reformation.