Chronic wounds remain a major clinical problem because they often heal slowly, require long-term treatment, incur high costs, and significantly reduce patients’ quality of life. This study aimed to develop a practical clinical algorithm to support everyday decision-making in the diagnosis and management of chronic wounds.

A narrative review of the current literature was conducted, covering wound pathophysiology, bacterial biofilms, the TIMERS framework, dressing selection, negative-pressure wound therapy, and surgical options. Based on this review, a step-by-step management algorithm was proposed. It includes patient and wound assessment, identification of barriers to healing, treatment of the underlying cause, wound bed preparation, infection control, and criteria for treatment escalation.

The proposed algorithm offers a structured yet flexible approach to chronic wound care. Further clinical validation is needed to confirm its usefulness in real-world practice.