We’ve all been there: You bump into the corner of the kitchen counter and bruise your arm or cut your finger preparing dinner. These common occurrences result in wounds that are typically minor and, in time, heal on their own.
But what do you do when a wound won’t heal? How do you know it’s time to seek medical attention?
Robert Skerker, MD, a physical medicine and rehabilitation doctor with Atlantic Health System and the medical director of Atlantic Health System Wound Healing Center at Morristown, offers insight into the signs a wound isn’t healing as it should and a few underlying medical conditions that can cause chronic wounds.
The Difference Between an Acute Wound and a Chronic Wound
An acute wound is a sudden injury to your skin. It’s caused by some form of trauma such as a cut, hit, or other type of impact. Normally, acute wounds heal themselves over a short time.
A chronic wound starts as an acute wound, but it doesn’t heal on its own
Signs a Wound Isn’t Healing Properly
While every person and every wound is different, there are some telltale signs that your wound isn’t healing as it should. The most common signs include the following characteristics:
- Foul smell or odor
- Oozing pus
- Pain or tenderness
- Spreading redness
- Swelling
All these traits signal inflammation and possible infection, requiring immediate medical attention.
“If the redness around a wound spreads — for example, if it starts at your toe and then spreads to your entire foot or up your leg — that’s a sign of an infection. If a wound produces a foul odor, that’s a strong indication of necrosis (dying tissue),” explains Dr. Skerker. “These are medical emergencies that need immediate care.”
Reasons Why a Wound Won’t Heal
Chronic wounds often have underlying causes. The most common include the following:
- Age: Healing slows as we age and people over age 70 often have thin skin, which tears more easily.
- Arterial vascular ulcers: Open leg sores caused by poor circulation are the result of damaged arteries.
- Blood thinner medication: Reduces blood clotting, causing wounds to bleed longer. Bruises can also lead to open wounds.
- Diabetes: Foot ulcers are a common and serious side effect of diabetes due to related nerve damage and poor blood circulation.
- Pressure ulcers: Open sores caused by being wheelchair-bound or bedridden.
- Some chronic or autoimmune conditions: such as lupus, inflammatory bowel diseases (IBD), and kidney disease — in particular, people receiving dialysis treatment.
- Venous leg ulcers: Open leg sores caused by damaged veins
Also, it’s important to note that, sometimes, cancer can present as a chronic wound — so it’s always a good idea to get it checked sooner rather than later.
When is it Time to Get Medical Help for an Unhealed Wound?
As a rule of thumb, Dr. Skerker advises patients to seek medical attention if a wound isn’t improving after 30 days. But he cautions people who have any of the previously mentioned underlying conditions not to wait.
“I tell my patients who have diabetes and other known medical conditions to come in immediately if they develop a new wound,” he says. “For them, unhealed wounds can have serious implications, including limb loss.”
Treatments for Chronic Wounds
Basic wound treatment involves four elements:
- Manage dead tissues at the base of the wound.
- Control local bacteria in the wound bed.
- Apply topical antimicrobial agents such as creams to clean and protect the wound.
- Control and reduce swelling.
The goal with all wound care is to create a moist environment that promotes healing.
“Using hydrogen peroxide to ‘clean’ a wound and then ‘airing it out’ are both outdated, inaccurate practices,” says Dr. Skerker. “You need to create a moisture-balanced environment for healing to occur. After that, treatment varies based on the severity and complexity of the wound and the patient’s overall health.”
For complex chronic wounds, advanced therapies are often required. Modality-specific options include:
- Cellular acellular matrix products (CAMPs) such as bilayer wound dressings and placental allografts
- Collagen applications
- Hyperbaric oxygen therapy (HBOT)
- Negative pressure wound therapy (NPWT), which is also called wound vac (vacuum-assisted closure)
- Nutritional supplementation and counseling
- Pressure offloading devices (including shoes and orthotics, canes, crutches, walkers and knee rollers)
- Total contact casting
- Ultrasound therapy
You can learn more about these and other wound healing care options at Atlantic Health System here.
The Wound Healing Centers at Atlantic Health System
Atlantic Health System has wound healing centers spanning northern and central New Jersey. The team of expert doctors, nurses and technicians is skilled at treating both typical (common) and atypical (less common) complex or chronic wounds. These may include:
- Diabetic foot ulcers
- Dialysis complications
- Complications from autoimmune and chronic diseases such as lupus, Crohn’s disease, ulcerative colitis and kidney disease
- Infected surgical or trauma wounds
- Pressure ulcers
- Venous leg ulcers
Regardless of the type of wound, Dr. Skerker says all patients receive comprehensive, personalized care to meet their specific needs. To learn more, visit Wound Healing at Atlantic Health System.
Key Takeaways
Chronic wounds can lead to serious health problems, including infections, loss of tissue, amputation and permanent disability. If a wound starts to hurt, ooze, or the redness and tenderness spreads, it could be a sign of an infection.
“Wounds that don’t heal need medical attention,” says Dr. Skerker. “If you have diabetes or other health conditions, don’t wait. We can treat those wounds before they cause even greater damage to your health and wellbeing.”
Be Proactive About Your Health
To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.