Wound healing at the local level: the stunned wound.

Many factors can negatively impact the wound-healing process leading to recalcitrant wounds. Biochemical and cellular commonalties can be identified across a number of wound etiologies. Healing data for various wound etiologies are presented, but these outcomes fail to show significant differences. Tissue perfusion, debridement, and wound fluid management can all impact healing. This review article discusses these topics and introduces a theoretical concept, the "stunned wound."