Why Wounds Won’t Heal (and What You Can Do to Help)
Sarah Wartman, MD
It’s estimated 6.5 million Americans are affected by chronic wounds
– wounds that don’t follow the expected pattern of healing
and show little or no signs of improvement after a month’s time.
More than an inconvenience or eyesore, those affected by non-healing wounds
can face chronic pain, loss of mobility, depression and anxiety, as well
as increased risk of hospitalization, amputation and death.
The most common types of chronic wounds are ulcers that fall into one of
- Diabetic ulcers: Foot ulcers are common in patients with diabetes who have
lost feeling in their legs and feet (called neuropathy)
- Pressure ulcers: More commonly referred to as bed sores, these ulcers are
caused by repeated friction or excessive pressure on a specific area over
a period of time
- Venous ulcers: Typically occurring in the lower leg, these wounds are the
result of vein valve malfunctions, which cause pressure to build up in
- Traumatic ulcers: Severe injury or bodily trauma can cause tissue damage
to an extent that it affects the healing process
- Arterial ulcers: Also called ischemic ulcers, these are caused by poor
or interrupted circulation, often due to smoking, diabetes, hypertension,
or blood clots
How are Chronic Wounds Treated?
Chronic wounds are the result of something interrupting the healing process.
Some of the most common causes of non-healing wounds include infection,
swelling from fluid buildup, and poor circulation. Each year, Americans
spend over $25 billion in the treatment of these wounds and related complications
– and that doesn’t include the treatment of underlying conditions like
diabetes and peripheral artery disease. Addressing these underlying conditions
is important to prevent future wounds and to ensure active wounds do not
become a chronic problem.
Due to the complexity of wounds and their underlying conditions, a multidisciplinary
physician panel is essential to adequately care for and, ultimately, heal
Washington Center for Wound Healing and Hyperbaric Medicine, it’s all hands on deck to treat these stubborn wounds. Our team
consists of infectious disease specialists, podiatrists, vascular surgeons,
plastic surgeons, general surgeons, internal medicine physicians and wound
specialist nurses and technicians. Outside of the Center, we’ll
often call upon the expertise of other specialists and subspecialists
to help a patient manage these underlying conditions. These can include
primary care providers, endocrinologists, cardiologists or even
Every patient is unique, so it stands to reason that not every wound is
alike. As such, we tailor treatments to each patient’s specific
needs. Some of the therapies and approaches that may be employed include:
- Vascular evaluation
Hyperbaric oxygen therapy
- Laboratory evaluation
- Infectious disease management
- Physical therapy
- Nutritional management
- Pain management
- Diabetic education
- Nuclear medicine
How can I help the healing process?
Patients should be vigilant about getting care if a wound isn’t healing
as expected. A patient without any known vascular issues or diabetes can
usually wait a few weeks to see if it improves. However, if you do have
one of these conditions, it’s important to be proactive and see
your doctor even before your wound is considered chronic.
Other ways you can help the healing process include:
- Manage underlying conditions – like diabetes or circulatory issues
– that may be complicating the healing process
- If possible, don’t take any medications (prescription or over-the-counter)
that may interfere with the healing process. Ask your wound care team
what medications you can and can’t take during treatment.
- Don’t smoke. Smoking exacerbates many of the underlying causes of
non-healing wounds, and interferes with the process of healing in the tissues
- Healing takes energy – energy that comes from calories in the food
you eat. A diet that includes plenty of lean proteins and healthy fats
can help fuel you through the healing process
- Keep your wound clean using warm water and a gentle baby wash. Antiseptics
like peroxide, iodine and alcohol can damage newly-formed tissues. After
cleaning, be sure to pat it dry to prevent infection
- Keep your wound dressed. Not only does it help prevent infection, wounds
heal best when in warm, dry conditions
- Keep up with doctor appointments. Chronic or non-healing wounds can be
stubborn. It may take a variety of therapies for them to heal completely.
Regular visits allow your doctor to assess the effectiveness of your current
treatment and, if needed, refer other specialists to help course correct
To learn more about the life- and quality of life-saving work that we do
at the Washington Center for Wound Healing and Hyperbaric Medicine,
visit the Washington Hospital website.
Posted July, 2019