Background: Hard-to-heal wounds is a phenomenon that affects several aspects of the sufferer's life. The healing nature of the wound creates a strain on the person and the health-care system. There is a lack of knowledge related to how people with hard-to-heal wounds experience their self-care. Aim: The aim of this study was to explore patients' experiences of self-care in relation to hard-to-heal wounds. Method: A qualitative systematic literature study with content analysis was conducted on 11 articles. Results: People with hard-to-heal wounds experienced worry related to their wounds, applying self-care and aggravating the wound. Connections were found between patient education, trust to the health care provider and adherence to self-care. Two categories were identified with three subcategories each. The significance of the care encounter with the subcategories; To participate in care, to feel fluctuating trust in the care relationship and to navigate instructions. Handling self-care in the everyday setting with the subcategories; the want to understand one’s condition, to relate to one’s condition, and to have feelings in different stages of self-care. Conclusions: People with hard-to-heal wounds experience worry and fear along with lack of knowledge regarding self-care management. When the care relationship and education fail there are consequences for the affected individual. Nurses have a responsibility to support and educate their patients based on their individual needs and ability. Orem´s self-care theory creates a solid foundation for nurses regarding patient instructions for self-care.