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Wound care: What you need to know |
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A skin wound that does not heal, heals gradually, or heals but is prone to recur is known as a chronic wound. More than half of the causes of chronic (ongoing) skin wounds include trauma, burns, skin cancers, infection, and diseases. Wounds that take a prolonged amount of time to heal require special attention.
Causes of chronic wounds
Some of the many causes of a chronic skin wound can include:
- Inability to move around (bed sores or pressure injuries), where prolonged localized pressure limits blood flow.
- Significant trauma injury to the skin
- Wounds (cuts made during operations) can become infected and take longer to heal after surgery.
- Deep burns
- Some underlying medical conditions, such as diabetes or certain types of vascular issues, can lead to sudden fainting.
- Specific kinds of infection, such as Bairnsdale or Buruli ulcers (Mycobacterium ulcerans)
- A lack of sensation in trophic ulcers permits their initial symptoms to persist and lead to an ulcer, such as in diabetic neuropathy and leprosy.
The healing process
The healing process of a skin wound follows a predictable pattern. A wound may fail to heal if one or more of the healing stages are interrupted. The normal wound healing stages include:- Inflammatory stage – Blood vessels at the site constrict (tighten) to stop blood loss and platelets (specialized clot-forming cells) gather to clean out a clot. Once the clot is created, blood vessels extend to carry blood to the affected region. That is why an inflamed place initially feels heated and looks and feels red.
- Fibroblastic stage - Collagen, the substance that gives skin its power, begins to grow in the body following a wound. The deposition of collagen speeds up the development of the edges of the wound and shrinks together. Small capillaries form at the site of the new skin to import blood.
- Maturation stage - The body constantly adds more collagen and refines the repaired area. This may take weeks or even years. That's why scars tend to fade with time and why we should take care of wounds for some time after they have healed.
Barriers to wound healing
Factors that can slow the wound healing process include:
- Dead skin (necrosis) - Dead skin cells and foreign materials prevent the body's natural healing process.
- Infection - A healthy wound may be the source of a bacterial infection. The body's immune cells deal with the infection rather than healing the wound.
- Hemorrhage - Persistent bleeding will keep the wound margins apart.
- Mechanical damage - For example, someone who is immobile is at risk for bedsores as a result of constant pressure and friction.
- Diet - The body may not be getting the right nutrients it needs to repair wounds, such as vitamins C, zinc, and protein.
- Medical conditions - That, such as diabetes, anemia, and some blood disorders that restrict blood flow, or other ailments that weaken the immune system.
- Age - Older people tend to have longer recovery times for wounds.
- Medicine - Certain drugs or treatments used in the treatment of some medical problems may influence the body's natural healing capacity.
- Smoking - Cigarette smoking can undermine physical recovery and cause health problems.
- Varicose veins - Restricted blood flow and swelling may result in skin breakdown and chronic ulceration.
- Dryness - Wounds, such as leg ulcers, that are exposed to the air are healed more slowly. Different cells, such as those in skin tissues and immune cells, require a moist environment for recovery.
Diagnosis methods
The cause of the chronic wound must be identified so that the underlying factors can be controlled. For example, if a leg or foot ulcer is a symptom of diabetes, your doctor will review the management of your blood sugar level and may recommend that you see a podiatrist to prevent recurring ulcers in the future. In the case of an ulcer caused by varicose veins, surgical elimination of the veins may be required.
Diagnosis methods for a chronic wound may include:
- A physical exam including inspection of the wound and assessment of its local nerve and blood flow is conducted.
- Your medical history, including details regarding your chronic medical conditions, recent surgical procedures, and medications that you usually take or have recently taken, will be recorded here.
- Blood and urine tests
- Biopsy of the wound
- The culture of a wound seeks out any (pathogenic) disease-causing microorganisms.
Treatment options
The treatment recommended by your doctor depends on your age, health, and the nature of your wound. General medical care may include:
- Cleaning is scrubbed out to remove muck and fresh-wound debris. This is often done in the shower, using a gentle movement and steady pressure.
- Tetanus vaccination may be required in cases of highly traumatic injury.
- The recovery from a more severe condition may require a specialist to survey and diagnose the wound. Local anesthetic will be offered before the procedure.
- Local anesthetic will be delivered in order to remove dead skin surgically.
- Closing large wounds with stitches or staples.
- Your doctor will likely prescribe a bandage for a healing wound based on the type and severity of the laceration. In some cases of chronic wounds, the doctor will recommend applying a moist dressing.
- Pain can cause the capillaries to constrict, which decreases healing. If your wound is causing your discomfort, talk to your doctor. The doctor may suggest that you take over-the-counter medications, such as paracetamol, or may prescribe stronger painkilling medications.
- Treating symptoms of infection, including pain, pus, and fever. The doctor will recommend antibiotics and antimicrobial alternatives if such treatment is warranted. Follow the instructions on the prescription label.
- Some medications, such as anti-inflammatory drugs and steroids, can disrupt your body's natural healing procedure. Tell your doctor about all other medications you take (including natural supplements) or have recently taken. The doctor may consider switching your dose or adding other medications so that your injury can heal quickly.
- Your physician might prescribe a variety of supports, such as stockings. Use these supports as directed by your doctor.
- Treating other ailments, such as anemia, may hinder your wound-healing process.
- Doctors may prescribe specific antibiotics to treat injuries resulting from Bairnsdale or Buruli ulcers. Skin grafts, in some cases, may be recommended.
- Recommending curative surgery or radiotherapy to eliminate the lesions of rodent ulcers (a non-contagious skin disease).
- Improving blood supply through vascular surgery, if diabetes or other issues associated with poor blood supply prevent wound healing.
Self-care suggestions
Be guided by your doctor, but self-care suggestions for slow-healing wounds include:- Do not take drugs that interfere with your body's innate recovery process if possible. For example, over-the-counter aspirin will inhibit the activity of immune system cells. Talk to your doctor about which medications to avoid for the shortest duration.
- Be sure to eat properly so your body can recover from injury.
- Be sure to add food items rich in vitamin C to your diet. The body needs vitamin C to create collagen. Consume plenty of fresh fruit and vegetables daily to supply your body with other nutrients vital for wound healing such as vitamin A, copper, and zinc. It might be beneficial to supplement your diet with extra vitamin C.
- Keep your wound dressed. Wounds heal faster if they are kept warm. Try to quickly change dressings. Exposure of a wound to the open air may increase its temperature and may prolong healing time for several hours.
- Make sure you have not used antiseptic creams or other solutions on a chronic wound. These solutions can affect wound-healing cells.
- Regular physical activity has a positive effect on your body's circulatory system and improves your overall health. Ask your doctor for advice on appropriate exercise.
- Manage any chronic medical conditions such as diabetes.
- Do not smoke.
Here at Pro Therapy Supplies, we have all the Wound Care Supplies that you might need. You may visit our website or call us at 770-441-9808 for assistance.
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