Wound care


Overview of wound care

While most wounds heal naturally over time, some require treatment.

Wound care is a medical specialty focused on treating wounds that are not healing. You will find this service in Dignity Health hospitals and specialized wound care centers. Typically, a team of healthcare providers, including doctors, nurses, and physical therapists, will work with you.

Visit a Dignity Health location to receive emergency care and ongoing treatment for wounds. For emergency services, call 911 or use our online waiting service to select an estimated arrival time at one of our ERs.

Visit an ER or urgent care center near you

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Symptoms

Wounds are considered non-healing if they do not show improvement after 30 days. In addition to not healing, some of the signs and symptoms include:

  • Numbness on or around the wound
  • Pain that is severe or increases over time
  • Changes in color
  • A foul odor emanating from the wound
  • Noticeable swelling around the wound
  • Fever or other signs of infection, such as redness or discharge

Causes

Non-healing wounds have several potential causes related to different underlying conditions.

To begin the healing process, wounds need an ample supply of oxygenated blood. Any condition which reduces blood flow can lead to poor wound healing.

For example, people who are bedridden or have conditions such as partial or complete paralysis may not be able to move often, leading to blood pooling and pressure-related injuries such as pressure ulcers or “bed sores.”

Patients with diabetes and peripheral neuropathy may experience poor wound healing due to decreased circulation, particularly in the feet and legs. Swelling (or “edema”) can limit healing for the same reason.

Infection, including fungal, bacterial, and viral infections, can also interfere with the body’s natural healing process.

In addition, reinjuring or reopening a previous injury can slow or stop the healing process. This is a particularly challenging factor for people who are paralyzed or partially paralyzed, since they may not notice or be able to feel an injury occurring or reoccurring in the same spot.

Poor nutrition, smoking, excess alcohol, and other factors can also affect healing. In some cases, non-healing wounds have no obvious cause.

Types

Serious wounds may take weeks or months to heal. In some cases, wounds are very resistant to the healing process and may never completely heal. Wound care is typically for non-healing wounds, such as pressure sores, sores from radiation exposure, and foot ulcers. Other possible types of wounds needing care include:

  • Cuts or lacerations
  • Burns  
  • Surgical wounds
  • Trauma wounds
  • Infected skin ulcers
  • Venous stasis ulcers (leg or ankle wounds caused by poorly functioning veins)

Risk factors

Some of the most common risk factors for non-healing wounds include:

  • Repetitive trauma or re-injury to a previous wound (such as accidentally ripping stitches)
  • Diabetes
  • Poor circulation (poor circulation can be caused by many other conditions, including diabetes)
  • A diet lacking in protein, or other forms of malnutrition
  • Lying or sitting in one spot for too long without moving (this can lead to pressure ulcers)
  • Swelling or edema
  • Infection
  • Exposure to some toxins, such as brown recluse spider venom

Prevention

Preventing wounds depends on the cause, location, severity, and type of wound.

Treating infections is one way to prevent worsening of a wound. Other underlying conditions, such as diabetes and paraplegia, may require more intensive, long-term monitoring to prevent wounds.

Depending on your overall health and medical history, taking steps such as engaging in regular exercise to increase circulation, losing weight, or stopping smoking, can help the healing process.

If you have already experienced an injury, taking care to protect the wound and keep it clean can also ensure your body heals faster and avoid the need for wound-healing therapies. Always seek treatment for severe wounds. 

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.


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