Figure 3.

Chronic wounds. Impaired macrophage function impairs phagocytosis, resulting in continued pathogenic colonization of the wound. In chronic wounds, macrophages also malfunction in their signaling role, resulting in increased pro-inflammatory cytokine production. Impaired communication and persistent infection lead to a prolonged inflammatory state, which inhibits fibroblast migration and angiogenesis. Eventually, persistent infection, hypoxemia, and insufficient tissue repair results in a chronic inflammatory state. Chronic inflammation creates a self-reinforcing positive feedback loop that leads to the formation of a chronic wound.