Hard-to-heal wounds have a significant impact on patients, clinicians and healthcare systems. Wounds impose a substantial health economic burden on the NHS, and much of this cost can be attributed to the burden of non-healing (or hard-to-heal) wounds. The NHS manages an estimated 278,000 venous leg ulcers (VLUs) every year, of which 47% do not heal within 12 months (Guest et al, 2018), with UK costs £1.98 billion (Phillips et al, 2020).