Overview of Wound Care and Non-Healing Wounds

Any wound that has not healed within four weeks is considered a chronic or non-healing wound. Over 6 million people in the US currently visit a doctor for a wound or ulcer that has not healed within this normal, expected healing time.


The Most Common Wound Types

1. Surgical wounds, traumatic wounds, cuts, lacerations, burns

2. Venous ulcers of the legs and ankles

3. Arterial ulcers of the legs and feet

4. Pressure sores/bed sores

5. Diabetic ulcers

Approximately one in 50 Americans will participate in consuming 40 billion dollars a year in dressing products and services alone, although wound care entails much more than simply dressing the wound or topical application. In fact, wound care has more to do with what is underlying the wound than the wound surface itself.

Only an expert in Wound Medicine/Wound Care will be able to accurately diagnose the wound healing problem and offer the appropriate treatment(s).


The Most Common Reasons for Non-Healing Wounds

1. Poor venous or arterial circulation – Wounds heal most efficiently when there is easy access to and from the wound site through the body’s circulatory system. When this process is impeded, proper healing cannot take place.

2. Edema – Fluid build up prevents proper blood flow, impeding the body’s natural healing process.

3. Poor nutrition (protein malnutrition) – Protein malnutrition, probably one of the most overlooked reasons as to why wounds will not heal, is another very significant factor to consider. Often, a substantial increase in ingested protein is needed to heal wounds. In fact, the amount of protein alone needed can be up to three times the recommended daily requirement.

4. Repetitive trauma to wound – This occurs when a wound undergoes repetitive pressure due to bumping, bending, flexing, or rubbing against a surface. This problem is exemplified in paraplegic patients since they cannot feel if part of their body is continuously bumping on their wheelchair. For instance, if one foot is constantly rubbing on the footrest of his wheelchair and the patient cannot feel that this is occurring, the repetitive trauma can and will prevent wound healing. Similarly, in spinal cord injury patients, pressure ulcers can develop due to lack of body movement such as when they are sleeping in the same position without the ability to shift, or even when watching a 90 minute movie without repositioning.

5. Infection – If a wound is infected, the proliferation of bacteria, virus or fungus in or under a wound site will inhibit the natural and timely healing process.

Written by Dr. Bruce Ruben, Encompass HealthCare, West Bloomfield, MI
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