pH profiling reveals progressive wound acidification during healing and higher pH in chronic non-healing wounds: a prospective, multicenter cohort study

The local microenvironment of wounds plays a crucial role in healing, with pH and temperature emerging as promising biomarkers. This prospective, multi-center, observational study assessed pH and temperature in acute and chronic wounds to identify physicochemical patterns associated with healing. A total of 117 patients with various wound etiologies underwent 226 pH and 181 temperature measurements at the wound center, edge, and surrounding skin. With a pH of 7.113 ± 0.659 and 7.043 ± 0.694, chronic and non-healing wounds exhibited significantly higher pH values than acute (6.592 ± 0.617) and healing wounds (6.820 ± 0.814; p<.05), with the wound center showing the largest difference (ΔpH = 0.52). A pH gradient was observed, decreasing from wound center to surrounding skin. Longitudinal analysis revealed a weekly pH decline of 0.05 units in healing wounds. Temperature showed a similar downward trend over time, though differences between groups were less pronounced. These findings indicate that progressive acidification of the wound environment correlates with healing, while alkaline pH is associated with chronicity and infection. Local pH, more so than temperature, may serve as a non-invasive, dynamic biomarker for wound monitoring and as a potential therapeutic target. Further interventional studies are warranted to evaluate pH-monitoring and potential modulation by wound therapies.