Chronic Wounds

What is a chronic wound?

Some wounds don't heal quickly. They take a long time to get better. These are called chronic wounds. Chronic wounds include:

• Venous leg wounds. These are shallow wounds. They happen when veins in the leg aren't working well.
• Wounds that result from diabetes. These happen when nerves are damaged, so you may not feel pain. High blood sugar can damage nerves. If you don't notice them, sores and infections or other problems may not get treated.
• Arterial ulcers. These are deep wounds that happen when there isn't enough blood flow to the legs or feet.
• Pressure injuries. These are wounds over bony parts of the body. They happen when you're not able to move well in bed or change your position when sitting.
• Wounds from surgery that were closed and then reopened on their own.

Caring for your chronic wound

Follow your doctor's instructions for how to care for the type of wound that you have. And know that your care team is there to help. While it may take some time, here are some things you can do to help your wound heal.

• Take your medicines exactly as prescribed. Be safe with medicines. Read and follow all instructions on t4he label.
  • Ask your doctor if you can take an over-the-counter pain medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • Take medicine to treat diabetes, if your doctor prescribes it. Having diabetes can make it hard for wounds to heal. So try to keep your blood sugar in its target range.
• Eat healthy foods. Healthy foods can help you heal. When your body is healing from a chronic wound, you may need extra calories and protein. Here are some ways to get the nutrition you need.
  • Eat three meals a day, plus snacks as needed.
  • Eat plenty of vegetables and fruits that are good sources of vitamins A and C. Try cantaloupe, oranges, grapefruit, broccoli, and carrots.
  • Include protein foods, like meat, poultry, fish, milk products, eggs, cooked dried beans, nuts, and tofu.
  • Keep healthy snacks around, like unsalted nuts, cottage cheese, and whole wheat crackers.
  • Ask your doctor about adding a liquid nutrition supplement to your diet. These can help you get extra protein, vitamins, and minerals.
• Don't smoke. Smoking affects blood flow and slows wound healing. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Stay hydrated. Water does a lot for your body. It helps transport nutrients and removes waste. This can help your body heal. Here are some ways you can stay hydrated.
  • Take frequent sips of water throughout the day.
  • Don't drink alcohol. It can make you dehydrated.
  • Drink plenty of fluids. But if you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• Keep pressure off the affected area. Follow your doctor's instructions about keeping pressure off your wound. Depending on what caused your wound and where it is, your doctor may suggest that you:
  • Use crutches or a wheelchair to keep weight off a leg or foot wound. Or you may need to wear a cast, walking boot, or special shoe to help protect your wound.
  • Change positions every 1 to 2 hours while you're sitting or lying down. This can help reduce pressure on the wound and skin. Even shifting your weight every 15 minutes while you're awake can help.
  • Use pressure-relieving supports. These can help relieve pressure on the affected area. Try a seat cushion that fits your wheelchair or a mattress that's filled with foam, air, fluid, or gel. Avoid donut-style cushions. These can reduce blood flow to the area and cause the wound to get worse.
• Use compression stockings. These can help decrease swelling in the affected area. Ask your doctor if you can use compression stockings for the type of wound that you have. Your doctor can show you how to use them.
• Elevate the affected area. Ask your doctor if elevating the area is helpful for the type of wound that you have. If they suggest it, prop up the area on a pillow anytime you sit or lie down. Try to keep it above the level of your heart. This will help reduce swelling.
• Be active. If your doctor says it's okay, try walking. This can improve blood flow to your legs.
• Take care of your wound. Follow your doctor's instructions about how to clean and cover your wound. If you did not get instructions, follow this general advice:
  • Clean the area with a gentle soap or wound cleanser.
  • Don't use hydrogen peroxide, alcohol, or harsh soaps. They can slow healing.
  • Don't soak the wound. Soaking can increase your risk of infection.