Wound-bed preparation: a vital step in the healing process.

Non-healing wounds are a significant burden to healthcare systems, where it is estimated that 4-5% of the adult population has a problem wound at any one time ( Guest et al, 2017 ). It is suggested that infection is the most frequent complication in non-healing wounds where it can prolong patient treatment times and increase resource use ( Gottrup et al, 2013 ). Wound infection develops as a result of an imbalance between the patient's immune system and the conditions in the wound, which subsequently can promote bacterial proliferation ( Wounds UK, 2013 ). It can impact on the patient by delaying wound healing, increasing the risk of amputation and life-threatening conditions, and reducing quality of life. The use of antibiotics to treat wound infections has decreased due to the increased risk of antibiotic resistance ( Swanson et al, 2014 ). As a result alternative strategies for preventing and managing wound infection have been adopted, including wound debridement and the use of topical antiseptic/antimicrobial agents.