When you get a cut or a scrape, a common solution is to clean and bandage it. The process is similar with small surgical incisions. If the healing process works, the wound will take care of itself.
Some wounds are much more serious. This often occurs when something interrupts the healing process. In this case, the wound may become chronic.
Types and Causes of Non-Healing Wounds
Four main categories of non-healing wounds exist:
1) Pressure Ulcers. These wounds develop when continuous pressure impacts the skin. They are common in individuals who are bedridden for long periods of time. For instance, someone who is in a coma or living with extreme obesity.
2) Diabetic Ulcers. Some people living with diabetes develop numbness in their lower extremities. They may suffer a wound to their feet or lower legs and not realize it. If left untreated, the wound can become chronic.
3) Venous Ulcers. Poor blood flow to the lower extremities can cause wounds surrounding the ankle area.
4) Arterial Ulcers. The arteries deliver crucial nutrients and oxygen to the body’s tissues. When they become blocked, those elements cannot provide important support. Then, a wound may grow and become infected.
Severe burns or animal bites also represent instances of potential non-healing wounds.
The biggest threats to the various types of wounds include:
- infection
- circulation issues
- age
- repeated trauma
- a weakened immune system
- history of smoking
- certain medications that disrupt the healing process
Symptoms of Non-Healing Wounds
As soon as you detect symptoms of a non-healing wound, it’s important to take action. Such symptoms may include:
- Evidence of increased redness or inflammation surrounding the wound
- Pain that does not improve or continues to get worse
- Discharge from the wound that may or may not emit an undesirable odor
- Dark purple or blue color surrounding the edges of the wound
What Solutions Are Available?
Many individuals seek care from their primary care provider (PCP), who may prescribe antibiotics or suggest surgical intervention. That can work in certain circumstances. Yet, if a wound is beyond those solutions, it needs intervention from a wound expert.
The first step is to identify why the wound is not healing. The next is to remove any dead tissue which attracts bacteria, causes inflammation, and incites infection. A process called surgical debridement removes any problematic tissue. Then, wound experts apply specialized topical antibacterial wound dressings.
Over the last two decades, these dressings have become more sophisticated and thus more effective. Some contain ionized silver, which helps healing. These dressings may last anywhere between two to seven days, depending on the amount of fluid discharge. The more fluid, the more often patients need to change the dressing.
For very complex non-healing wounds, experts may recommend hyperbaric oxygen therapy (HBOT). This treatment increases the amount of oxygen blood cells can carry, which assists wound healing. Other treatments include skin substitutes and collagens. These expedite the healing process as well.
Treatment providers will also discuss the importance of smoking cessation, a balanced diet, protein intake, effective diabetes control and long-term care. These are all integral to the healing process. Ignoring these factors can compromise healing.
Treatment Follow-Up
Chronic wounds take time to heal. Patients should visit their advising physician every one to two weeks to ensure healing is progressing as expected. In some cases, patients need an adjusted treatment plan. As healing progresses, patients may also benefit from using compression bandages, especially if they have edema in their lower extremities.
If you or a loved one is experiencing any issues with non-healing wounds, see your PCP as soon as possible. They can then refer you to a wound center for more advanced care.
Listen to Podcasts
A non-healing wound is very concerning. The good news is that viable options do exist. In this podcast episode, we visit with Sherif Osman, MD, CWS, FAPWCA, Medical Director of the Wound Care Clinic at UM Upper Chesapeake Health. Dr. Osman provides important information surrounding the risks, causes, and treatment options for non-healing wounds.
Advanced wound care requires specialized treatments. In this podcast, learn from Loren Elchik, CRNP, WCC, a wound care specialist at UM Upper Chesapeake Health, where you should go for the right kind of care.
More to Read
- What Are Vascular Disease and Vascular Screenings?
- Should I Go to the ER, Urgent Care or Primary Care?
- Does Your Burn Need Medical Attention?
- How to Tell If a Cut Is Infected or Healing
Medically reviewed by Loren Elchik, CRNP, WCC.
