What Is A Non-healing Wound? You cut your foot while walking barefoot.

For most people, thats nothing some antiseptic ointment and a Band-Aid wont fix. But if you have diabetes, a circulatory problem, or a compromised immune system, that cut could turn into a serious problem. A non-healing or chronic wound is defined as a wound that shows little or no improvement after four weeks or does not heal in eight weeks. A non-healing wound poses the risk of infection, which can lead to a more serious condition, possibly resulting in the loss of a limb. Some of the most common areas for non-healing wounds are the lower extremities such as feet, ankles, heels and calves. For those unable to walk, common places for non-healing wounds are hips, thighs and buttocks. When it comes to wound healing, its all about blood supply. Blood brings oxygen, plasma, platelets and a host of other nutrients to help the wound heal. People with diabetes, heart disease, existing infections or lung disease have difficulty getting oxygen-rich blood to their wound, especially if the wound is located in a lower extremity, such as a foot or ankle. People who eat poorly, are alcoholics or smoke may also have problems getting adequate blood flow to a wound. Without adequate blood flow to a wound, tissue dies in a process called necrosis or gangrene. Dead tissue is a breeding ground for bacteria and a perfect environment for infection. Treatment for Chronic Wounds When a person has a non-healing wound, one of the first things done at a wound care center is to remove contaminants in and around the wound. If there is dead tissue around the wound, that tissue needs to be debrided or excised. Debridement can be done surgically, with special chemicals, or with rapidly pulsing water. Some wound care facilities have been known use sterile maggots to clear dead tissue. While this therapy is approved by the Food and Drug Administration, it has limits. Maggot larvae have to be shipped and there is a wait. Also, there is a time limit on how long you can use them, and some patients are averse to having insects on them. Wound healing is all about getting oxygen-rich blood to the wound. Debridement makes the wound look larger and angrier, but its a sure way to rid the wound of the medium that breeds infection, as well as getting blood supply to the wound. Bacteria such as Staphylococcus and Pseudomonas are ever-present on our skin and in the environment. When were healthy and wound-free, these bacteria dont present a problem. But a wound opens the door to infection. Color, texture, odor and warmth in and around the wound area are all signs that an infection

may exist. The longer you have a wound, the broader the spectrum of antimicrobial agents needed to treat it. This is especially true if your immune system is compromised. Today we have a wide array of topical antibiotic gels and ointments that can keep bacteria in check, as well as maintain a moist environment for the wound to heal. Common wisdom once held that wounds had to be kept dry. Weve since learned that wounds heal faster in a moist environment, particularly when the moisture contains the bodys own tissue fluid and cells. A moist environment for healing is best achieved when using a dressing that keeps air out. This type of dressing allows the bodys own chemistry to control infection and provide nutrients to the cells involved in wound repair. MY REACTION If you get a cut or a wound, here are a few basics: Clean the wound with antibacterial soap and stop bleeding with a bandage. Antibacterial ointment should be used, but people with diabetes and circulatory problems need to avoid strong antiseptics such as hydrogen peroxide or povidone-iodine (Betadine), which can damage skin and interfere with healing. Once bleeding stops, keep the wound semi-moist. You can do this using overthe-counter wound care products, including petroleum jelly. Finally, watch the wound carefully. If you dont see signs of healing after four weeks, you may need to have the wound evaluated by a doctor.