The Complete Guide to Chronic Wound Care and Open Wound Healing by Center for Advanced Wound Care
Ever thought about how we take care of wounds that just won’t heal? Well, if a wound doesn’t heal on its own or takes much time, it’s labeled a chronic wound. If you want to learn more about chronic wounds, their causes, and their treatment, you have arrived at the right page.
The Center for Advanced Wound Care has a guide that spills the beans on how it all works. We are talking about the science of healing and practical tips for looking after wounds. Let’s explore the secrets that turn stubborn wounds into stories of bouncing back and getting better.
What Is a Chronic Wound?
All wounds that occur in your body start with an acute wound, which is an injury to the skin that occurs suddenly rather than over time and heals within a time period.
But these acute wounds turn into chronic wounds when they don’t heal on time. Chronic wounds go through a set of stages or don’t heal within three months.
Reports show that 1–2% of people in developed countries suffer from chronic wounds at least once in their lifetime. In the United States, chronic wounds impact more than 8.5 million people and have become one of the fastest-growing problems.
Chronic wounds in individuals come in different forms and sizes in multiple body areas.
Ulcers are the most common type of chronic wound that pops up for many reasons, so you have to keep an eye out for any symptoms.
Common Types of Chronic Wounds
Below, we have listed the types of chronic wound ulcers.
Diabetic ulcers
If an individual fails to manage their diabetes better, it can cause complications, especially in the lower part of the body. Diabetic foot ulcers are one of those that occur due to poor blood circulation and nerve damage. These ulcers simply start with small cuts or blisters and gradually develop calluses, which then break down and form ulcers.
This is why diabetic management is significant. Consult your doctor regularly, and check your feet for signs of ulcer development.
Pressure ulcers
Pressure ulcers are also called bedsores. These occur when there’s prolonged pressure on the skin, often when an individual is bedridden or uses a wheelchair. These are found on bony areas including the elbows, shoulder blades, heels, knees, spine, or even the back of the head.
This ulcer type progresses through four stages, beginning with tenderness and then developing into full-thickness ulcers that affect deeper levels of underlying tissue.
Venous ulcers
Did you know that venous ulcers represent about half of chronic ulcers?
They develop in the lower leg and form when the valves inside the veins stop functioning properly. This results in blood pooling in the veins.
These wounds begin with venous diseases like varicose veins and chronic venous insufficiency and get worse with time when left untreated.
Arterial ulcers
If you think that your veins are the sole reason for ulcers, you are wrong. Because arterial problems can also lead to ulcers, when there’s an insufficient supply of nutrients in the blood to the lower extremities in individuals suffering from arterial disease, arterial ulcers occur.
If you experience pain in your legs after exercising or when your legs are elevated, it could signal an arterial ulcer.
Also, if you have high blood pressure, obesity, renal failure, or any history of vascular disease, you are at risk of this ulcer.
Surgical wounds
When you undergo surgery, you will probably have wounds from the incision. In most cases, these wounds heal on their own.
Post-surgical chronic wounds are wounds that persist or have difficulty healing after a surgical procedure. These wounds often result from various factors, including if there’s damage to the blood supply or if you don’t care for the surgical wound properly. Surgical wounds that have turned chronic appear hot, swollen, and reddish.
Their management often involves addressing specific issues associated with the surgical site.
Traumatic wounds
Severe injuries occur due to accidents, falls, or other traumas and don’t heal due to the extent of the injury or complications. To treat this, you need immediate and appropriate care for the initial injury, along with ongoing wound management, infection control, and, if needed, surgical interventions.
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Open Wound Healing Stages
When a wound starts healing, it progresses through four physiological stages of healing, including hemostasis, inflammation, proliferation, and maturation.
But why should you know about the stages of open wound healing? Because only when you have an understanding of these stages will you learn when a chronic wound occurs.
These four stages must occur properly, and if they don’t, it becomes a chronic wound.
When a wound gets stuck in the inflammatory phase, it develops into a chronic wound.
Different wound healing stages:
Stage 1: Hemostasis
Hemostasis occurs immediately or within a few minutes after an injury.
When a wound occurs, naturally, your blood vessels start to reduce bleeding, and platelets clot to stop excessive bleeding. This is the first response to the injury.
Stage 2: Inflammatory phase
This phase is important because it protects the wound from infection. Early inflammation is a good indication that white blood cells, platelets, and other cells are working to remove debris and bacteria and stimulate healing. The area may become red, swollen, and warm as a result of increased blood flow.
Stage 3: Proliferative Phase
During the proliferative phase, it can last from 3 days to several weeks.
In this phase, new tissue, known as granulation tissue, starts to form. Then, blood vessels grow to supply the developing tissue, and fibroblasts produce collagen, which strengthens the wound. Epithelial cells also migrate to cover the wound surface.
The proliferative phase also helps the wound become smaller and less noticeable. You will see pink and red tissue that signals successful and healthy wound healing.
Stage 4: Maturation phase
Maturation is the final phase where the wound starts to close.
This phase usually begins around week 3 and can sometimes last up to 12 months. The excess collagen starts to degrade, and the wound contraction starts to peak around week 3.
Wound contraction occurs more frequently in secondary healing than in primary healing. The scar strength increases to approximately 80% of the original tissue.
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What Causes a Chronic Wound Infection?
If a wound goes through all four healing stages, it heals without any issues. But not all wounds proceed that way. There are multiple physiologic and mechanical factors that can interfere with the healing process and lead to chronic wounds. Some of the factors include diabetes, immunodeficiency, trauma, and malnutrition.
To make things worse, a chronic wound is at risk of infection, especially when exposed to additional risk factors such as poor wound cleaning, uncontrolled blood sugar levels, a compromised immune system, etc.
- Poor wound hygiene
For the most part, wound cleaning can seem simple, but it greatly helps heal the wound faster. But issues arise when the wound cleaning is not done correctly. When left uncleaned, the wound area becomes an environment that harbors bacteria growth.
- Impaired blood flow
Insufficient blood circulation to the wound site can also slow down the natural healing processes. This can increase the risk of infection.
- Imbalanced blood sugar
If you are diabetic, you are at risk. Diabetes develops when your body cannot produce or use insulin.
When insulin fails to do its job of transforming sugar into usable energy, then it can cause severe health complications.
- Foreign bodies in the wound
The chronic wound can easily become the breeding ground for bacteria if it contains debris, foreign objects, or non-healing tissue within the wound.
- Contamination during dressing changes
If wound dressings or bandages are not changed using aseptic techniques, there is a risk of introducing bacteria into the wound.
- Poor nutrition
If individuals have an inadequate supply of nutrients, such as vitamins and minerals, it can compromise their body’s ability to repair tissues and fight off infections. So, people with chronic wounds must follow a healthy diet.
How Long Do Chronic Wounds Need to Heal?
“Can a chronic wound ever heal?” is one of the most searched questions.
There is no straight-forward answer to this because healing can’t always be predicted, and it differs for every individual. Some factors that influence the healing of chronic wounds include age, the condition of the wound, and the treatments undertaken, among other factors.
Chronic Wound Treatment by the Center for Advanced Wound Care
- Cleaning the wound
The chronic wound is first cleaned when the dressing is changed, using a saline solution.
- Debridement
When treating chronic wounds, the healthcare professional will remove dead or inflamed tissue. This procedure is called debridement.
The tissue is removed using instruments such as tweezers to help clean the wound. Since this procedure is painful, the patient is given a local anesthetic to numb the wound.
- Wound dressings
After cleaning the wound, it is covered with a dressing. Providing a moist environment, absorbing excess exudate, and preventing further infection are the benefits of wound dressings.
Different dressing types include films, gauges, hydrogel dressings, hydrocolloid dressings, and foam dressings.
If you ask what is the fastest way to heal a chronic wound, understand that wounds heal faster when they are kept warm. So be very quick when changing dressings. Why so?
When exposing a wound to open air, it can drop in temperature and slow healing for a few hours.
Dressings are there to soak up extra fluids from the wound and keep it safe from infections. Usually, they stay on for a few days. But if you notice they are not soaking up the wound secretions anymore, if they move around, or if there’s any fluid leaking from the bandage, it’s a good idea to change them.
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Conclusion
Dealing with chronic wounds can be a real pain, both physically and emotionally. It’s just frustrating, and it can also be risky.
Whether it’s for yourself or someone you care about, we hope you are better informed about chronic wounds, their causes, and chronic wound treatment options.
If you are ready to take the next step towards optimal wound care and the path to healing, get in touch with the experts at the Center for Advanced Wound Care today.
