Why Wounds Won’t Heal (and What You Can Do to Help)

Author: Sarah Wartman, MD​
Specialty: Vascular Surgery

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 five categories:

• 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 the tissues
• 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 these wounds.

At the 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 dietitians.

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
• Debridement
• Hyperbaric oxygen therapy
• Laboratory evaluation
• Infectious disease management
• Physical therapy
• Nutritional management
• Pain management
• Diabetic education
• Nuclear medicine
• Radiology

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