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The complexity of chronic wounds represents a challenge for development of new therapies, but these are urgently needed because of the extent of morbidity and mortality and the inadequacy of existing approaches. PDT represents a novel and promising treatment option because it has a unique antimicrobial action, not readily susceptible to the development of resistance and also because it may induce a host response, resulting in stimulation of growth factor production. However, the multi-factorial nature of chronic wounds should be recognised in the design of clinical trials, which require delivery, not just of PDT alone, but PDT superimposed on existing standard wound management. This chapter discusses the challenges in development of antimicrobial PDT for chronic wound treatment and how they are being overcome in ongoing clinical studies.

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