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Chronic Wound Info

Chronic Wounds and Non Healing wounds info

Chronic Wounds: A Comprehensive Guide

Wounds are a common part of life. They can be caused by accidents, surgery or even chronic medical conditions. While most wounds heal on their own with proper care, some can become infected or develop complications. This page is designed to provide you with comprehensive information about all types of wounds, from minor cuts and scrapes to complex surgical incisions and chronic wounds.

Types of Chronic Wounds Q & A

Diabetic foot ulcers
What are Diabetic Foot Ulcers?

Diabetic foot ulcers are open sores or wounds that develop on the feet of people with diabetes. They are a serious complication of diabetes and can lead to several health problems, including:
Infection: People with diabetes often have poor circulation and impaired immune function, making them more susceptible to infections in their feet. These infections can be difficult to treat and can spread to the bone, potentially leading to amputation.
Amputation: If a diabetic foot ulcer becomes infected or doesn't heal properly, it may be necessary to amputate the affected toe, foot or part of the leg.
Gangrene: In severe cases, the lack of blood flow to the foot can lead to tissue death, known as gangrene. This usually necessitates amputation to prevent the spread of dead tissue.

Here's what causes diabetic foot ulcers:
Nerve damage (neuropathy): High blood sugar levels can damage the nerves in your feet, leading to numbness and loss of sensation. This can make it difficult to feel injuries or irritation, which can then develop into ulcers.
Poor circulation: Diabetes can also damage the blood vessels in your feet, reducing blood flow. This makes it harder for your feet to heal from injuries and fight off infections.
Pressure: Ill-fitting shoes, bunions, hammertoes, and other foot deformities can put excessive pressure on certain areas of your feet, increasing the risk of ulcers.

It's important to be aware of the risk factors and take steps to prevent diabetic foot ulcers, such as:

  1. Checking your feet daily for any cuts, sores, or redness.

  2. Washing your feet daily with warm water and mild soap.

  3. Moisturizing your feet to prevent dryness and cracking.

  4. Wearing well-fitting shoes that provide good support.

  5. Keeping your blood sugar levels under control.

  6. Seeing your doctor regularly for foot exams.

ischemic wounds
What are Ischemic wounds ?

Ischemic wounds are open sores or tissue damage caused by a lack of blood flow to a specific area of the body. This lack of oxygen and nutrients impairs the healing process and makes the wounds challenging to manage.

Here's what you need to know about ischemic wounds

Peripheral arterial disease (PAD): This is the most common cause, where arteries harden and narrow, restricting blood flow to the legs.
Diabetes: Can damage nerves and blood vessels, increasing the risk of ischemic wounds.
Trauma: Injuries can damage blood vessels, leading to localized ischemia.
Vasculitis: Inflammation of blood vessels can restrict blood flow.
Other conditions: Raynaud's disease, Buerger's disease and frostbite can also contribute.

Slow healing wounds: Ischemic wounds typically heal very slowly or not at all.
Pain: The affected area may ache, throb, or feel numb.
Changes in skin color: The skin may appear pale, red, or discolored.
Shiny, tight skin: Skin may seem stretched and glossy due to poor blood flow.
Hair loss: The affected area may lack hair growth.
Coolness to the touch: The skin may feel colder than other areas.
Gangrene: In severe cases, tissue death can occur, requiring amputation.


Addressing the underlying cause: This is crucial for long-term wound healing. For PAD, this may involve medications, lifestyle changes or even surgery.
Improving blood flow: Medications, angioplasty or bypass surgery may be used to improve blood flow to the affected area.
Wound care: Debridement (removing dead tissue), dressings and infection control are essential for wound healing.
Hyperbaric oxygen therapy: This therapy exposes the wound to pure oxygen at increased pressure, promoting healing.

What are bedsores?

Bedsores, also known as pressure ulcers or pressure injuries, are open wounds that develop on the skin and underlying tissues due to prolonged pressure. They typically occur when individuals with limited mobility remain in the same position for extended periods, leading to reduced blood flow in certain areas. This lack of blood flow deprives the skin and tissues of oxygen and nutrients, ultimately causing cell death and the formation of an open wound.

Here are some key points about bedsores:

Who is at risk?

  • People who are bedridden or use wheelchairs for extended periods

  • Individuals with conditions affecting their ability to move or feel pain, such as spinal cord injuries, stroke or diabetes

  • Malnourished individuals with poor skin health

Where do they develop?
Bony prominences like heels, ankles, hips, buttocks and shoulder blades

Areas subjected to friction or shearing forces, like the tailbone or backs of knees



  • Discolored skin (red, purple, or darkened)

  • Warmth, pain, or tenderness in the affected area

  • Swelling

  • Blistering

  • Skin breakdown and open wound formation



  • Infection, which can be serious and potentially life-threatening

  • Amputation, in severe cases

  • Increased hospital stays and healthcare costs



  1. Frequent repositioning (every 2 hours for high-risk individuals)

  2. Pressure-relieving support surfaces like special mattresses and cushions

  3. Skin care, including regular cleaning and moisturizing

  4. Maintaining good nutrition and hydration

  5. Addressing any underlying medical conditions


Depends on the severity of the bedsore
May involve wound care, debridement (removing dead tissue), medications, and potentially surgery in severe cases

Seeking medical attention:

It's crucial to see a doctor at the first sign of a bedsore for proper diagnosis and treatment to prevent complications.

surgical wounds
What are Surgical Wounds?

Surgical wounds, also known as incisions, are controlled cuts made by a surgeon during a medical procedure. They are essential for accessing the area of concern, performing the necessary repair or removal and then allowing for proper healing. 

Types of Surgical Wounds:
Clean wounds: These are wounds made during procedures where there is minimal risk of infection, such as removing a benign tumor or performing cataract surgery.
Clean-contaminated wounds: These wounds involve some potential for contamination, such as during appendectomy or gallbladder removal.
Contaminated wounds: These wounds involve a higher risk of infection, such as those made during bowel surgery or treating an abscess.
Dirty/infected wounds: These wounds are already infected at the time of surgery, such as debriding necrotic tissue.


Closure of Surgical Wounds:
Surgical wounds are closed using various methods depending on the size, location, and type of wound. 


These methods include:
Sutures (stitches): These are thread-like materials used to close the wound edges. They can be absorbable (dissolve over time) or non-absorbable (need to be removed by a healthcare professional).
Staples: These are metal clips used to close the wound edges, often used for skin incisions.
Adhesives: Surgical glue or special tapes can be used to close small wounds or supplement other closure methods.


Healing Process:
Surgical wound healing typically goes through several stages:

  • Inflammation (3-5 days): The body's initial response to injury, involving redness, swelling, and pain.

  • Proliferation (7-14 days): New blood vessels and tissue form to rebuild the damaged area.

  • Maturation (3 weeks - several months): The wound strengthens and gains scar tissue.

  • Remodeling (up to 1 year): The scar continues to mature and flatten.


Care for Surgical Wounds:

Proper care is crucial for optimal healing and preventing complications like infection. This may involve:

  1. Keeping the wound clean and dry.

  2. Changing dressings as instructed by your healthcare provider.

  3. Taking prescribed pain medication.

  4. Avoiding strenuous activities that strain the wound.

  5. Attending follow-up appointments to monitor healing.


Risks and Complications:

While most surgical wounds heal well, some risks and complications can occur, such as:
Infection: One of the most common complications, requiring prompt antibiotic treatment.
Bleeding: Excessive bleeding can occur during or after surgery, requiring intervention.
Pain: While expected, severe or persistent pain should be reported to your healthcare provider.
Scarring: Most surgical wounds leave some degree of scarring, which may improve over time.

radiation wounds
What are Radiation wounds?

There are 2 types of Radiation Wounds

1. Skin damage from radiation therapy:

This is the most common meaning of "radiation wounds" in the medical field. It refers to the skin damage that can occur as a side effect of radiation therapy used to treat cancer. While radiation therapy targets cancer cells, it can also affect healthy tissues, including the skin. 

This damage can manifest in various ways, depending on the dose and duration of radiation exposure:
Acute Radiation Dermatitis: This is the early response, showing up within weeks of treatment and causing symptoms like redness, dryness, itching and peeling.
Chronic Radiation Dermatitis: This develops later, months or even years after treatment, and can involve changes in skin pigmentation, hair loss and even ulceration.

These wounds typically heal over time with proper care, but managing them and minimizing discomfort is crucial. This can involve skincare measures, medications and potentially specific wound care strategies.

2. Injuries from acute high-dose radiation exposure:

This refers to wounds caused by a single, large dose of ionizing radiation, not radiation therapy. This can occur in accidents involving nuclear materials or radioactive sources. The severity and type of injury depend on various factors, including the radiation dose, exposure duration, and affected body area. These injuries can range from localized skin burns to more severe damage to deeper tissues, organs and even bone marrow.

Treatment for such wounds requires specialized medical care and may involve wound management, supportive measures and potentially medications or specialized procedures depending on the extent of the injury.

infectious wounds
What are Infectious  wounds?

Infectious wounds are wounds that have become colonized by harmful bacteria, viruses, or other microorganisms, leading to an inflammatory response and potentially serious complications. 

Common Causes:
Breaks in the skin: Cuts, scrapes, bites, punctures, burns, and surgical incisions can provide an entry point for pathogens.
Underlying medical conditions: Diabetes, malnutrition, and immune system disorders can increase susceptibility to infections.
Poor wound care: Improper cleaning, bandaging, or moisture management can create a favorable environment for bacterial growth.
Exposure to contaminated environments: Wounds exposed to dirt, animal feces, or stagnant water are more likely to become infected.

Signs and Symptoms:

  • Increased redness, swelling, and pain around the wound.

  • Warmth to the touch.

  • Pus or drainage from the wound.

  • Fever and chills.

  • Delayed healing or worsening of the wound.


Types of Infectious Wounds:

  1. Superficial skin infections: These involve only the top layers of skin and typically cause mild symptoms like redness, pus, and pain.

  2. Deep tissue infections: These extend deeper into the skin, muscles, or even bones, potentially leading to serious complications like sepsis or tissue death.

  3. Chronic wounds: These wounds can become infected due to underlying health conditions or poor blood circulation, making them difficult to heal and more susceptible to infection.



Treatment for infectious wounds depends on the severity and type of infection. It typically involves:
Antibiotics: These medications target and kill the specific bacteria causing the infection.
Wound cleaning and debridement: Removing dead tissue and foreign objects from the wound helps prevent further infection and promotes healing.
Dressing changes: Regular wound cleaning and dressing changes are crucial to keep the wound clean and promote healing.
Surgery: In severe cases, surgery may be needed to remove infected tissue or repair damaged structures.


Proper wound care: Clean and dress wounds regularly with sterile materials.
Maintain good hygiene: Wash hands frequently and keep the wound site clean.
Vaccinations: Stay up-to-date on recommended vaccinations to prevent infections like tetanus.
Manage underlying conditions: Control diabetes and other medical conditions that can increase infection risk.

Seek medical attention promptly: If you notice signs of infection, consult a healthcare professional immediately.

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