Wound Management

Wound Care for Chronic Wounds & Other Boo-Boos

Chronic wounds are scabs and sores that don't heal as expected. Unlike acute wounds, which typically heal within a predictable timeframe, these persist for an extended period and may resist basic wound care.

The most common types of non-healing wounds include diabetic ulcers, pressure ulcers, surgical wounds, and venous ulcers, to name a few. These non-healing wounds often result from underlying medical conditions, and addressing these factors that impair the normal healing process is essential.  

First Course of Action To Treat Wounds

If a wound does not show any signs of healing after eight weeks, it is classified as a chronic wound. Like acute wounds, local treatment for non-healing wounds aims to reduce pain, itching, infection, and bleeding. It also addresses issues such as excess fluid and foul odor, which can affect patients physically and emotionally. 

There are eight guidelines for basic wound care -  

• Wash your hands 
• Stop the bleeding 
• Clean the wound 
• Apply antibiotic gel 
• Cover the wound 
• Watch for infection 
• Change the wound dressing 
• Tetanus shot (if necessary)  

Treatment for Chronic Wounds

Removing dead tissue and using an appropriate dressing is essential to prepare the wound for proper healing. 

1. Cleaning the wound

The wound is debrided or cleaned using a saline solution before covering it with a bandage. Use a gauze swab or gently clean the wound in a back-and-forth motion. Start from the center and move outward. Avoid excessive scrubbing, as it can damage healthy tissue. If the injury is severe, debridement may be painful. Use a local anesthetic to numb the wound or take painkillers if needed.

2. Wound dressings

The cleaned wound is then covered with a moist dressing that removes excess fluid and protects it from infection. The best suitable dressings for chronic wound care may include:  

• Hydrocolloid dressings
• Transparent films
• Gauze dressings
• Hydrogel dressings
• Silver dressings
• Alginate dressings
• Foam dressings
• Honey dressings

Some of these dressings contain hormone-like substances that aid in a quicker healing process by promoting cell growth. Dressings on non-healing wounds are left on for several days and should be changed if there is leakage, or the bandage comes off. Using a dressing with manuka honey has been found to promote healing in chronic wounds. 

3. Compression

Compressing the wound site helps provide damaged tissues with oxygenated blood for quick wound healing. Compression stockings or compression bandages offer the optimal pressure required for veins to carry the blood from the heart to the wound site and vice versa.

4. Antibiotics

Infection can make healing wounds difficult. Your doctor will prescribe antibiotics based on the severity of the infection. Antibiotics can be used topically on the wound site or placed on the wound using a compress. Studies have shown that antibiotics help diabetic foot ulcers heal faster; however, whether this also holds true for other chronic wounds is unclear.

5. Hyperbaric oxygen therapy

Found to improve and lessen the healing time of diabetic foot ulcers, in Hyperbaric therapy, the patient enters a special oxygen chamber to breathe oxygen under high pressure. This treatment increases oxygen concentration and enhances the blood supply to the wound area. 

6. Negative pressure wound therapy

NPWT, also called vacuum-assisted closure or VAC therapy, aims to increase blood flow to the wound. It also helps keep the wound moist to improve the healing process. An airtight dressing connected to a pump by a thin tube is placed on the wound. The pump sucks the exudate from the wound, creating negative pressure on the wound surface. The negative pressure is applied to the wound around the clock or at regular intervals. 

This therapy is used in some hospitals to cure wounds that are large and difficult to heal. However, NPWT is also used to treat chronic wounds at home.

Also known as vacuum-assisted closure or VAC therapy, NPWT aims to increase blood flow to the wound. It also helps keep the wound moist to improve the healing process. An airtight dressing connected to a pump by a thin tube is placed on the wound. The pump sucks the exudate from the wound, creating negative pressure on its surface. This negative pressure can be applied to the wound around the clock or at regular intervals.  

This therapy is used in some hospitals to cure wounds that are large and difficult to heal. However, NPWT is also used to treat chronic wounds at home. 

7. Skin grafts

Skin grafting is a viable treatment option if a chronic wound is too large to close. In this method, a small portion of skin is taken from another part of the body, typically the thigh, and transplanted onto the wound site. Grafts are also made from synthetic material and human cell products. Studies have shown chronic foot wounds heal faster after a skin graft than from standard treatment.

How to heal wounds faster naturally?

Sores that don't heal can put extreme stress on the body and require more nutrients and calories to heal such wounds. Foods that help heal wounds naturally include - 

1. Protein

Protein provides the building material for muscle and skin repair. It also helps boost immunity. Lean meat such as beef, pork, chicken, fish, peas, lentils, tofu, nuts, peanut butter, seeds, eggs, yogurt, and cheese are readily available protein-packed foods. 

2. Carbohydrates

Carbs supply the energy required for quick healing. Some carbs-rich foods include whole grain bread, cereals, potatoes, pasta, rice, fruits and veggies, etc. 

3. Vitamin A

Bright orange fruits and vegetables and dark green leafy vegetables are rich in vitamin A and stimulate epidermal turnover to restore the epithelial structure. 

4. Vitamin C

Citrus fruits, tomatoes, peppers, cantaloupe, broccoli, and strawberries are rich sources of vitamin C help boost collagen production. It also helps promote pressure ulcer healing.

If you have diabetes, follow your diabetic diet and medication recommendations. Consult your healthcare provider or dietitian for help if the chronic wound is not healing.

 

5. Water

Water is vital to our health and helps heal wounds by replacing fluid lost from draining wounds. Make sure to drink about 6 to 8 cups of liquids daily unless your doctor tells you otherwise. 

6. Pain Management

Pain killers like acetaminophen or ibuprofen can help with mild to moderate pain. If the pain does not ease after taking these medicines, consult your doctor, who may prescribe a stronger drug. Psychological support can also help cope with chronic wound pain.

Work with your doctor to develop a cohesive wound care plan that best fits you, and visit HPFY for any of your wound care needs.

 

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