Chronic wounds can be stubborn and debilitating, but many effective wound care methods are available.
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Throughout someone's lifetime, experiencing a wound is often considered commonplace. Most wounds successfully heal on their own without specific medical intervention. However, some wounds require medical care beyond general first aid principles.
It can be frustrating and discouraging to have a wound, especially if it is healing slowly. However, many effective methods of wound care can improve healing. Read on to learn more about wounds and how our providers at Lompoc Health excel in comprehensive wound care.
Definition of Wounds
Wounds, which the U.S. National Library of Medicine defines as breakdowns in the integrity of the skin’s surface, can affect people of all ages. Common types of wounds include scratches, cuts, scrapes, punctures, and ulcers.
When a wound is initially sustained—from a fall, burn, increased pressure, surgery, or another injury to the skin's integrity—it is considered an acute wound. Wounds that are cared for in the acute phase, with proper first aid measures such as cleaning, dressing, and (if necessary) suturing, generally heal within one month. However, when a wound is present for 30 or more days, it is considered to have a prolonged healing time, and it is referred to as a “chronic wound.”
Chronic wounds are becoming more common. Some reports estimate that nearly 7 million people in the U.S. have a chronic wound.
Risks of Chronic Wounds
People who have certain medical conditions have a higher risk of experiencing prolonged wound healing time. Risk factors for chronic wounds include:
- Diabetes mellitus
- Cigarette smoking
- Circulatory problems such as peripheral artery disease (PAD) or venous insufficiency
- Increasing age
- Nutritional deficiencies
- High blood pressure
- Renal disease
- Limited mobility
- Immunosuppressive conditions
- Use of certain medications, such as corticosteroids
Risks of Untreated Wounds
It can be intimidating to take the first step in initiating wound care. However, it is essential to address chronic wounds promptly before they have a chance to create larger problems. The risks of untreated (or insufficiently treated) wounds include the following:
- Infection of the underlying bone (osteomyelitis)
- Functional loss
- Chronic pain
- Systemic infection
To avoid experiencing a chronic wound, it is important to stay in close contact with your medical provider, particularly if you have chronic illnesses that put you at a higher risk for developing a chronic wound. If you have diabetes, prevention strategies such as daily foot inspection and wearing protective shoes can help reduce your chance of suffering a chronic wound.
Where Chronic Wounds Commonly Occur
Acute wounds can occur anywhere. When wounds take longer to heal and become chronic, they are more likely to be located in places where circulation (blood flow) is reduced, with decreased sensation or increased pressure or friction.
Common sites for chronic wounds include:
- Bottom of the feet (“plantar wounds”)
- Overlying bony areas of the buttocks (such as the coccyx or sacrum)
- Overlying other bony areas, such as the elbows, hips, or heels
- Intertriginous areas (between skin flaps)
Chronic Wound Appearance
A chronic wound can have certain characteristic appearances. When it comes to pressure ulcers, clinicians use a wound’s appearance to assign it to a specific stage. The criteria for these stages include the following:
- Stage 1: Color changes (red, maroon, or a purple hue of the skin).
- Stage 2: Loss of the top layer of skin, with a pink and red wound bed visible. Blisters may appear.
- Stage 3: Loss of the enter skin layer, with visible fat below.
- Stage 4: Visible muscle, bone, or other structures (such as fascia, ligaments, or tendons).
The stage of a wound can determine the type of wound care needed for it to heal maximally.
If you are concerned about a wound that is not healing properly, it is important to follow up with your medical provider. Your provider will do a physical assessment of the wound and order further diagnostic studies, such as blood work or an x-ray or MRI. If your provider suspects that a problem with blood flow causes your wound, you may be eligible for specific studies that evaluate how well your blood is flowing. If the wound appears infected, a tissue culture may help with antibiotic therapy.
Methods of Wound Care
When it comes to wound care, one of the most important things your clinician can do is determine the factors that led to the development of the wound in the first place. You may find that you need an alternative pair of shoes or different patterns and habits during your daily routine.
Once your wound has been fully evaluated, your provider will have all the information necessary to formulate a wound care plan. There are many effective wound care methods available, including the following:
Non-surgical Wound Care
Ways of caring for a wound that does not involve surgery include:
- Pressure redistribution (using dedicated pillows or mattresses, or a repositioning schedule) or mechanical offloading
- Physical therapy
- Nutritional optimization
- Specific types of wound dressings that aim to keep the wound in an optimal state (usually moist)
- Local tissue removal (also known as wound debridement)
- Chronic disease optimization
- Compression therapy
Surgical Wound Care
Most chronic wounds can be successfully managed without surgery. However, some wounds require surgical attention, such as the following:
- Delayed closure
- Skin grafts or flaps
- Surgical attention to the underlying causative problem
- Revascularization procedures
At Lompoc Health, our surgeons have a high level of expertise. They can determine what type of wound closure method is preferable given each individuals’ unique medical circumstances.
How to Learn More About Wound Care
Wounds, particularly chronic wounds, are so common that clinicians are dedicated specifically to caring for them. If you are concerned about a wound taking a long time to heal, make sure to discuss this with your primary care provider. You may benefit from the specific expertise of a wound care specialist. Contact us today to learn more.