Complex or hard‐to‐heal wounds continue to be a challenge because of the negative impact they have on patients, caregivers, and all the associated costs. This study aimed to identify prognostic factors for the delayed healing of complex wounds. Five databases and grey literature were the sources used to research adults with pressure ulcers/injuries, venous leg ulcers, critical limb‐threatening ischaemia, or diabetic foot ulcers and report the prognostic factors for delayed healing in all care settings. In the last 5 years, a total of 42 original peer‐reviewed articles were deemed eligible for this scoping review that followed the JBI recommendations and checklist PRISMA‐ScR. The most frequent prognostic factors found with statistical significance coinciding with various wound aetiologies were: gender (male), renal disease, diabetes, peripheral arterial disease, the decline in activities of daily life, wound duration, wound area, wound location, high‐stage WIfI classification, gangrene, infection, previous ulcers, and low ankle brachial index. It will be essential to apply critical appraisal tools and assessment risk of bias to the included studies, making it possible to make recommendations for clinical practice and build prognostic models. Future studies are recommended because the potential for healing through identification of prognostic factors can be determined, thus allowing an appropriate therapeutic plan to be developed.

The wound microbiome refers to the specific community of microbes, including bacteria, fungi, and other microorganisms, that are present in and around a wound. This microbiome plays a crucial role in wound healing, as it includes both healing-promoting and pathogenic microbes. The balance between these microbes significantly influences the healing process; a balanced microbial colonization can support wound healing and prevent infections, while an overgrowth of pathogenic microbes can lead to delayed healing processes and complications. The composition of the wound microbiome can vary depending on the type of wound, cause, genetic predisposition, and (social) environment. In this scope review, the complex interactions in the wound microbiome will be highlighted and the importance of non-pathogenic microbes for wound healing will be discussed. In addition, possible therapeutic approaches to restore a healthy microbiome and prevent infections will be addressed. A deeper understanding of these dynamics could open up new perspectives for the treatment of wounds and the development of strategies to combat wound infections.

Complex, chronic or hard‐to‐heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann–Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non‐adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti‐inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision‐making in wound care.

(1) Background: The high prevalence of persons with wounds and its consequences for a person’s quality of life makes the issue a relevant focus of attention for healthcare professionals. Through prognostic factors for healing, the individual risk of complications can be predicted, is possible to predict imminent delays and guide decision-making, thus helping healthcare professionals. (2) Methods: A scoping review performed according to JBI methodology and guided by the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR) checklist will aim to identify the studies that meet predefined eligibility criteria. Five databases and gray literature will be the sources used to research adults with pressure ulcers, venous leg ulcers, arterial ulcers, or diabetic foot ulcers and report the prognostic factors for delayed healing in any care setting. (3) Results: This review will consider all quantitative and mixed studies in the last five years. The selection of articles will be carried out by two reviewers independently, using EndNoteWeb and Rayyan. Prognostic factors will be presented by design study, sampling, setting, outcome, wound type, and statistical methods. (4) Conclusions: Mapping prognostic factors for delayed healing could also be a starting point for a systematic review and meta-analyses to quantify the value of each factor.

Background. It is a reality of care praxis that it is difficult for healthcare professionals to assess and monitor the local status of wounds objectively and regularly. This study aims to identify the minimum data required to evaluate patients with complex wounds to be incorporated into mHealth. Methods. Descriptive qualitative study, based on thematic analysis, using the online focus group technique. An intentional sample was selected, and two separate sessions were held, attended by 6 experts and 7 nurses. The data were coded by two researchers, with a deductive method, using NVivo software. Results. 5 themes emerged which are described as follows: assessment of patients with complex wounds, distinctive criteria based on the type of wound, flowcharts for approaching patients with wounds, characteristics of a mobile application focused on wound care, and alerts to be included in a mobile health application dedicated to wound treatment. The theme characteristics of a mobile application for approaching the patient with wounds raised 4 subthemes: (1) image, (2) communication, (3) decision‐making, and (4) safety. Conclusion. The use of wound assessment tools provides data capable of generating quality care outcome indicators. These serve as good practice guides, enhancing health gains, whether they are economic or quality‐of‐life improvements.