To me, the key formula in understanding the Wronskian of a linear homogeneous first order differential system is the following:
$$
\text{if}\quad \frac{d A}{dt}(t)=B(t)A(t)\quad \text{then}\quad \frac{d}{dt}\left(\det A(t)\right) = \mathrm{tr}\, B(t)\det A(t).$$
Here $A, B$ are square matrices and $\mathrm{tr}$ stands for "trace" and this formula is often called "Liouville's formula".
You apply it as follows. Consider the system of $n$ differential equations
$$
\frac{d\boldsymbol{x}}{dt} = B(t) \boldsymbol x(t).$$
(Boldface denotes elements of $\mathbb R^n$, considered as column vectors). Taking $n$ solutions $\boldsymbol{x}_1\ldots \boldsymbol{x}_n$ one forms the matrix
$$
A(t)=\begin{bmatrix} \boldsymbol{x}_1,\ \ldots\, , \boldsymbol{x}_n\end{bmatrix}\in\mathbb{R}^{n\times n}.$$
The Wronskian determinant $\det A(t)$ is geometrically interpreted as the oriented volume of the parallelepiped spanned by $\boldsymbol{x}_1\ldots \boldsymbol{x}_n$. Liouville's formula says that this volume's evolution is governed by the trace of $B(t)$.
For a single differential equation of order $n$
$$
x^{(n)}(t)+ b_{n-1}(t)x^{(n-1)}(t)+\ldots +b_0(t) x(t) = 0$$
one introduces the vector
$$
\boldsymbol{x}(t)= \begin{bmatrix} x(t) \\ x'(t) \\ \vdots \\ x^{(n-1)}(t)\end{bmatrix}$$
and the matrix ("companion matrix")
$$
B(t)=\begin{bmatrix} 0& 1& 0& \ldots& \ldots& \ldots \\
0 & 0 & 1 & 0 & \ldots&\ldots \\
& & &\vdots & & \\
0& \ldots& \ldots& \ldots& 0 & 1 \\ -b_0(t) & -b_1(t)& \ldots &\ldots & -b_{n-2}(t) & -b_{n-1}(t)\end{bmatrix}$$
so that the equation is equivalent to $\frac{d\boldsymbol{x}}{dt}=B(t)\boldsymbol{x}(t)$. Often, one says that $\boldsymbol{x}$ belongs to the phase space of the original equation. (This is especially true when $n=2$, in which case the phase space is typically interpreted the Cartesian product of position and velocity.)
In the case of a linear homogeneous differential equation of order $n$, the Wronskian is interpreted as an oriented volume in phase space. Liouville's formula says that the evolution of the Wronskian is governed by the term $\mathrm{tr}\, (B(t))=-b_{n-1}(t)$.
Further development. This interpretation fits well in the frame of Liouville's theorem for Hamiltonian systems. See also here.