Chronic wounds represent a significant health care challenge, especially among older adults. The prevalence of chronic nonhealing wounds in developed countries is 1% to 2% of the general population, but rises to as high as 15% in Medicare beneficiaries [1]. In this population, the combination of multiple comorbidities and age-related physiologic changes contributes to both the onset and chronicity of nonhealing wounds. Venous ulcers account for 85% of all leg ulcers in this demographic, with reported incidence of 4% to 5% in people older than 65 years and incidence up to four times higher in adults older than 80 years [2,3]. Arterial (ischemic) ulcers, often associated with peripheral arterial disease (PAD), become more common as people age; > 10% of people older than 65 years have evidence of PAD [4]. Diabetic foot ulcers (DFUs), which develop in up to 34% of patients with diabetes, disproportionately affect older adults due to their higher prevalence of diabetes, compounding the impact of neuropathy and vascular complications [5]. Pressure ulcers also remain a critical concern in the older adult population; driven by decreased mobility, poor nutrition, and comorbidity burden, the problem is exacerbated in long-term care facilities, where reported prevalence reaches 28% [6].

Chronic wounds lead to frequent infections, hospitalizations, and extended lengths of hospital stay, substantially raising morbidity and mortality; in particular, the presence of DFUs or ischemic foot ulcers correlates with markedly increased mortality over 1- and 5-year intervals [7]. Furthermore, the economic implications are profound, with annual US expenditures on wound care estimated to exceed $28 billion to $97 billion, factoring in both direct medical costs—such as specialized dressings, advanced wound therapies, and surgical interventions—and indirect costs related to caregiver burden and loss of productivity [1]. Chronic wounds in older adults also diminish quality of life through persistent pain, reduced mobility, social isolation, and psychological distress.

Routine care by health care providers and caretakers for nonhealing wounds in older adult patients, compared with their younger counterparts, is challenged by medical and socioeconomic factors that, in turn, significantly affect their quality of life and morbidity [8,9]. In this literature review, we summarized insights on publications in the last 10 years regarding the pathophysiology, current and developing therapeutic modalities, and socioeconomic considerations of older adult patients living with nonhealing wounds.