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Ongoing Monitoring Schedule When to Discontinue Stop GHK-Cu and evaluate further if: Serum copper exceeds 155 mcg/dL on two consecutive measurements New hepatic enzyme elevation exceeds 2x the upper limit of normal The wound shows signs of clinical infection (increased erythema, purulence, pain, odor) Contact dermatitis develops at the application site The wound fails to show any measurable improvement by week 8 The Wound Healing Society's 2022 guidelines recommend that any wound failing to reduce in area by 40% at 4 weeks with a given therapy is unlikely to heal with that therapy alone, and a change in approach should be considered [14]