Human Wound and Its Burden: Updated 2025 Compendium of Estimates.

Chronic wounds are a silent epidemic in the United States, affecting one in six Medicare beneficiaries-about 10.5 million people-and costing Medicare an estimated $22.5 billion annually. While outpatient wound care costs dropped from $10.5 billion in 2014 to $2.5 billion in 2019, physician office costs rose to $4.1 billion, reflecting a shift in care delivery. Globally, wound care expenditure reached a staggering $148.65 billion in 2022. Despite this burden, federal research funding remains disproportionately low. Chronic wounds often recur due to incomplete healing. Many wounds close by resurfacing without discharge but fail to restore the skin's barrier function-measured by transepidermal water loss at the site of closure-making them prone to reopening. Outcomes of recent patient-based studies advocate redefining wound closure endpoint to include full barrier restoration. The 2023 Wound Balance Framework promotes holistic, patient-centered care, while cutting-edge technologies are reshaping the field. Bioengineered skin therapies can reduce healing time. Machine learning tools, such as scanning electron microscopy-based trainable Weka (Waikato Environment for Knowledge Analysis) intelligent segmentation technology, detect biofilms, while other tools predict healing outcomes and amputation risks. Multiomics technologies identify biomarkers such as Fos-related antigen 1 (FOSL1), enabling precision therapies tailored to wound phase and patient biology. Telehealth is proving to be transformative for wound care. A 2023 meta-analysis of 2,397 patients showed it significantly reduced healing time, pain, and amputation rates. Policy is catching up: Centers for Medicare & Medicaid Services doubled allowable skin substitute applications (from four to eight) and extended treatment windows to 16 weeks. The Better Wound Care at Home Act established national payment for disposable negative pressure wound therapy, and the Lymphedema Treatment Act mandated Medicare coverage for compression garments, projected to save $1.3-$1.5 billion over 10 years. Together, these advances signal a shift toward proactive, personalized, and equitable wound care-driven by science, guided by ethics, supported by policy, and centered on patients. [Figure: see text].