Emerging Role of transmission electron microscopy in the Diagnosis of chronic wounds

Abstract

Background: Chronic wounds are increasingly understood to stall because of matrix-enclosed bacterial biofilm and senescent host ultrastructure that light microscopy and culture cannot resolve [1,7].

Objective: This review synthesizes TEM's contribution to chronic wound diagnosis across biofilm architecture, exudate extracellular vesicles, and nanomaterial dressing characterization.

Methods: We synthesized peer-reviewed literature in which TEM or a closely related method generated the tissue- or particle-level findings discussed.

Findings: Biofilm is detected in a pooled 78.2% of chronic wounds against 6.0% of acute wounds [18], with TEM resolving a matrix-enclosed, non-randomly distributed bacterial architecture underlying treatment resistance [3,10]; TEM is likewise the reference method confirming wound-exudate extracellular vesicles [24,25] and verifying nanomaterial dressing particle characteristics [28].

Conclusions: TEM has moved chronic wound science toward a mechanistic account grounded in directly visualized nanoscale architecture, with its translational role still expanding [21,23].