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Posted: Monday, August 9, 2021

Treating Chronic Wounds

Have you ever had a wound that just wouldn’t heal? You’re definitely not alone. A 2018 analysis of Medicare beneficiaries found that an estimated 8.2 million people had chronic wounds, with estimated treatment costs totaling billions of dollars. The aging population, diabetics and people struggling with obesity all are susceptible to experiencing chronic wounds. But, while many suffer chronic wounds in silence, it’s important to know that there are treatments available.

Melissa Young from Blount Memorial Total Rehabilitation’s MEND clinic says a chronic wound is one that either doesn’t heal quickly or fails to heal at all. “Chronic wounds don’t progress through the healing cascade,” she said. “The healing cascade consists of four phases: hemostasis, inflammatory, proliferation and maturation. The first three phases occur over a period of about a month, but the last phase of maturation can take up to two years. The maturation phase is a remodeling phase that occurs after the wound has closed. Therefore, any wound that takes longer than 30 days to close or doesn’t progress through the healing cascade can be considered a chronic wound,” she explained. “It is possible to help your wounds heal by getting rid of factors that get in the way of wound healing and improving the conditions that help your wound close,” she added.

Young says identifying the type of wound is critically important. “Once the wound is identified, a plan can be developed to promote healing,” Young said. “For diabetic patients, this may include taking pressure off the wound, and teaching them how important it is to keep their blood sugars monitored and normalized. For those with pressure wounds, the important factor is to find the source of the pressure and remove it, which can mean prescribing a gel mattress overlay or a waffle air cushion to use when the patient is sitting, or identifying a position that increases a pressure point and changing that position,” she explained. “Patients with pressure wounds need their nutrition assessed, as well,” she added.

“A chronic venous ulcer requires getting rid of leg swelling to heal the wound,” Young continued. “It also is very important to keep the swelling from returning after the wound heals by using compression. Venous wounds will reoccur if swelling is not controlled. Arterial wounds may require vascular procedures to be considered ‘healable.’ We can identify vascular issues by ordering arterial and venous imaging tests to complete the picture about what is happening in the extremity. Other wounds may be infected and require antibiotics. Non-healing surgical wounds may require negative pressure wound therapy to help close the wounds,” she said. “Regardless of type, though, all wounds need good wound care hygiene,” she added.

Many people with chronic wounds don’t seek the treatment they should due to stigmas surrounding their condition. “Wounds can have a social, financial and psychological effect on the patients,” Young said. “Wounds can isolate patients from friends and family because of drainage management issues, pain or even odor. They can interfere with patients’ ability to continue to do the things they enjoy or be around the people they love. A patient’s perception of his or her wound may include embarrassment, humiliation, guilt and shame, all of which may carry over to the family member who cares for the patient on a daily basis. If one notes any of the above emotions, please seek help. A patient can follow up with his or her primary care physician, specialist or make an appointment with our outpatient wound center,” she said. “The most-important aspect is to share how you are feeling with someone and get help,” she added.

For more information about wound care and chronic wounds, call Blount Memorial Total Rehabilitation’s MEND clinic at 865-980-5089.

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