With an estimate of 40 million chronic wounds worldwide *26, chronic wounds represent a silent epidemic that affects a large fraction of the world population and poses a major threat to the public health and economy. In developed countries, it has been estimated that 1 to 2% of the population will experience a chronic wound during their lifetime. *9,10 In the United States alone, chronic wounds affect 6.5 million patients. *11 In the Scandinavian countries, the associated costs account for 2–4% of the total health care expenses.*12 The burden of treating chronic wounds is growing rapidly due to increasing health care costs, an aging population and, in the United States and beyond, a sharp rise in the incidence of diabetes and obesity worldwide. It is claimed that an excess of US$25 billion is spent annually on treatments of chronic wounds. *9
The major types of chronic wounds include venous leg ulcers, diabetic foot ulcers, and pressure ulcers. Chronic wounds fail to proceed through the normal phases of wound healing in an orderly and timely manner. Chronic wounds affect a large percentage of the population, particularly in western communities, and are a significant socio-economic burden encompassing hospitalization, patient suffering, loss of employment, reduced quality of life, and early death. This situation is further enhanced by the worldwide increase in metabolic diseases, such as diabetes and obesity, and ageing populations. Chronic leg and foot ulcers last on average 12 to 13 months, recur in up to 60% to 70% of patients, can lead to loss of function and decreased quality of life, and are a signiﬁcant cause of morbidity. *8
Biofilm infections are common in chronic wounds and increase disease severity by stimulating chronic inflammation at the wound site (REF). Current treatments with antibiotics are not effective against biofilms and contribute to the development and spread of antibiotic resistant microorganisms. Novel antimicrobial agents targeting biofilms in wounds are highly needed to eliminate wound infections and restore normal wound healing (REF).