Usually, any wound or injury a person gets will, with appropriate treatment, heal in a timely manner. Wound healing goes through orderly and predictable stages; a trained medical professional can tell how old an injury is by looking at it and determining what stage the healing has reached. Sometimes, though, a person will have a medical condition, an infection, or a particularly severe injury that does not heal appropriately. It gets stuck at one of the stages or even worsens.
Chronic wounds are wounds that have not healed within six weeks. Other signs that a wound may be becoming chronic include:
- pus in the wound – yellow, green, or white
- black or dark skin around the wound
- dead tissue in or around the wound
- fever around the wound,
- cold or pale flesh around the wound
- decreased pulse around the wound,
- worsening of the wound
- swelling that does not decrease in the appropriate amount of time
- difficulty moving the part of the body where the wound is located
The most common types of chronic wounds are the various kinds of ulcers: venous(caused by poor circulation in the blood vessels), diabetic (thought to be related to both neuropathy and the way diabetes affects the way the body heals), and pressure (related to ischemia caused by pressure due to lack of movement). Surgical incisions, necrotic tissue, malnutrition, burns, and radiation injuries are also possible sources of chronic wounds.
There are several things that can cause a wound to become chronic. Often, a wound has several factors that work together to cause the wound not to heal.
- Poor circulation of blood or oxygen – This is known as ischemia. It can have several causes, such as swelling from a traumatic injury, pressure, and disorders of the blood vessels. Heart disease and liver disorders can decrease blood circulation. Lung disorders and smoking can decrease available oxygen.
- Weak immune system – This can be caused by an autoimmune disorder, by some medications, by radiation, or by conditions like diabetes or cancer.
- Infections – An infection can be introduced into a wound from a foreign object or dirt being in the wound. Inadequate wound care following an injury or surgery can allow an infection to set in. Poor oxygen supply can increase chances of infection. Conditions like diabetes, or other diseases that lower your immune system, can increase the risk of infection.
- Age – As a person ages, their healing systems slow. Healing takes longer. They are also more likely to develop other conditions that negatively impact healing, and are more fragile and easily damaged.
There are many options available for healing deep, slow-healing wounds. A wound treatment team will first evaluate the wound to discover what is causing it to become chronic. They will take a medical history. They will ask about the history of that wound. They will check for infection, including doing blood tests and a wound culture. They may take an x-ray to check how the wound is affecting bones and tissues in the area around it.
Then they will first work to remove the cause of the wound becoming chronic. If the patient has an infection, they will be treated for the infection. Caregivers will drain pus, debride necrotic tissue, and carefully clean out any objects, dirt, or material that is in the wound and preventing healing. If it is a pressure ulcer, a treatment plan to remove the pressure from the area and prevent other ulcers from forming will be put into place.
Once the wound is clean and treatments for infections are underway, it will be kept scrupulously clean with sterile water. Specialized dressings will be used to keep the wound clean and moist. Dressings can include gauze, gels, foams, bandages, films, or even skin grafts. They may be used to apply gentle pressure, which can encourage healing.
Patients may receive additional healing supports such as a wound vac, which uses carefully calibrated suction to remove waste and fluid, encourage the edges of the wound to come together, and improves circulation. They may even use a hyperbaric chamber, which supplies extra oxygen in a specially pressurized chamber to encourage healing. Patients might also receive pain management treatments if their wound is causing them high levels of pain.
You do not have to live with the pain and anxiety that a chronic wound causes. Great Neck Family Foot Care is experienced and capable in dealing with healing difficult wounds. Contact us to discuss your healing.