Advancing Wound Balance: Clinical Perspectives and Practical Approaches for Implementation in France​

A French multidisciplinary panel of wound care specialists, including geriatricians, physical medicine physicians, podiatrists and specialist nurses, convened to explore the practical implementation of the Wound Balance concept across diverse clinical settings in France.

The panel confirmed Wound Balance as a straightforward and adaptable framework applicable to all wound aetiologies, representing a fundamental shift from merely managing wounds toward actively pursuing healing at the earliest possible stage.

The report addresses key challenges in French wound care: a persistent knowledge gap between specialist clinicians and primary care nurses, a rise in wound diagnoses among patients with diabetes and pressure ulcers alongside a concurrent decline in preventive care consultations, and language barriers affecting patient engagement. Structured education, peer mentorship and expanded telemedicine are identified as critical enablers for earlier and more consistent interventions. Pressure ulcer prevention is explicitly framed as a structural quality and safety indicator for healthcare systems - largely preventable when organisation, education and monitoring are in place.

Clinically, the panel recommends debridement as the first intervention step for wounds presenting with red flags such as infection risk or biofilm. Recognising clinical signs of biomarker imbalance - including excessive exudate, fibrin, slough, pain and malodour - is highlighted as essential for timely action. The Philippe Léger (2019) 8-question assessment checklist is recommended as a practical tool for structured wound evaluation. Autolytic debridement using Hydro-Responsive Wound Dressings such as HydroClean® requires no specialist training and is well-suited to primary care. SAP dressings, including RespoSorb® Silicone Border, are recommended across all wound aetiologies from initial debridement through to epithelialisation, supporting exudate management and removal of healing inhibitors throughout the full healing journey.

Overall, patient quality of life is a non-negotiable pillar. The panel specifically highlights that language such as "non-compliant" is counterproductive. Non-concordance should be seen as a signal for improved communication, not patient fault. Shared decision-making, Whole-person assessment and a strong therapeutic alliance are central to achieving optimal healing outcomes.

Dr Emmanuelle Candas, Dr Florian Dumas, Dr Sandrine Robineau, Dr Chloé Geri-Pecher, Véronique Labbé-Gentils, Magali Veiga Marques.