The quest for tissue repair's holy grail: The promise of wound diagnostics or just another fishing expedition?

In both Celtic and later Norman Arthurian legend, the Fisher King was a man charged with keeping and protecting the Holy Grail. He suffered from perpetual non-healing wounds, which could only be healed once the hero and most worthy of knights, Perceval, could answer the question “who does the Grail serve?” In this manuscript, we ask the same question in a slightly more modern context. It has become evident that perpetually using empiricism and clinical guesswork alone is insufficient to improve tissue repair beyond its present state. Real time or near-real-time diagnostics and theragnostics to identify progress are essential adjuncts to realize real improvements. We review recent and near-future advances in whole-genome sequencing, community profiling, inflammation measurements, peri-wound receptor viability, pH and regional perfusion indices as potentially promising interim sites to measure. In this manner, by measuring what we manage, perhaps we can avoid costly fishing expeditions and help our patients heal. This is a quest that we feel is not only noble, but also essential.