Wound Care For Chronic Wounds

What is a Chronic Wound?

Wounds can occur due to an injury when the skin is torn, cut, or punctured. If you have a wound that won’t heal, it is referred to as “chronic.” These types of wounds can be caused by diabetes, vascular disease (arterial, venous, or lymphatic conditions), radiation therapy, surgery, trauma, burns, or pressure. The vast majority of chronic wounds are venous ulcers, arterial wounds, and diabetic or pressure ulcers. The most common wounds that many podiatrists treat are diabetic foot ulcers.

What Type of Chronic Wounds Are Treated?

Chronic wounds are usually classified into different categories, with the majority related to ulcers due to disease. The types of categories include:

• Venous and Arterial Ulcers - venous ulcers occur in the lower extremities and are thought to be due to venous hypertension. This can result in tissue damage that leads to chronic wounds.
• Diabetic Ulcers – Diabetic ulcers are the most common type of chronic wound treated by podiatrists. Diabetes causes neuropathy, which inhibits the perception of pain. This can cause wounds to go unnoticed and thus, lead to infection. Diabetes also compromises the immune system which can cause chronic wounds.
• Pressure Ulcers - Another leading type of chronic wounds are pressure ulcers. Pressure ulcers are caused by ischemia that occurs when pressure on the tissue restricts blood flow into the area.

What Treatments Are Available?

Treatment for chronic wounds will begin with an assessment of the wound itself. The location of the wound and how severe it is will be a factor in treating it. If the underlying condition is a problem such as diabetes, that will be addressed as well. Any of the following medications and treatments may be used for care of chronic wounds:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) help decrease swelling, pain, or fever.
• Acetaminophen to decrease pain and fever.
• Antibiotics to prevent or treat an infection caused by bacteria.
• Cleansing or flushing of the wound with sterile water kills germs.
• Debridement to remove anything from the wound that can delay healing and lead to infection such as dead tissue.
• Wound dressings to protect the wound from further injury and infection. Dressings may be in the form of bandages, gauze, films, gels, or foams.