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. 2022 Sep 15;20(4):1292–1303. doi: 10.1111/iwj.13960

FIGURE 2.

FIGURE 2

The damage spiral in (potentially infected) chronic wounds, where bacterial infections both intensify the direct cell and tissue damage by bacterial toxins and produce additional proteases which degrade extracellular matrix and inhibit healing (built upon the Cullen's circle of delayed wound healing depicted in Gibson et al., 2009). ROS, reactive oxygen species