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Wound management

Wound care frequently asked questions (FAQs)

What is a chronic wound?
A chronic wound is generally a wound that doesn't start to heal within four weeks or hasn't healed within eight weeks.

What causes a chronic wound?
While underlying causes of chronic wounds vary from patient to patient, they tend to occur in patients with poor blood circulation, diabetes, or for other reasons related to a patient's condition. Pressure ulcers (sometimes called 'bed sores'), for example, can develop in nursing home patients who are confined to bed, and can evolve into chronic wounds. Likewise, for a person with diabetes, a simple foot blister may result in a chronic open sore, serious infection, gangrene, and may even require amputation.

How are chronic wounds treated?
At Health First Wound Management, each patient undergoes an initial evaluation of the wound, medical history, and current health. Blood tests, and other laboratory work-ups that provide information about blood and oxygen flow, may be ordered. Once test results are compiled, the physician determines if an underlying condition, such as diabetes, is inhibiting the natural healing process.

Next, an individualized, aggressive treatment program is planned, and specialists are brought into the case depending upon the assessment. Health First Wound Management is comprised of a multidisciplinary medical team as well as other local independent physicians specializing in podiatry, neurology, internal medicine, and general surgery.

Treatment is typically three-fold:

1. If an underlying cause, such as diabetes, is diagnosed, the team ensures that the patient's primary physician is managing this underlying cause. Frequent communication between the patient's primary physician and wound physician is essential, and benefits the patient's care in the wound program.

2. Special treatment for the wound itself is ordered.

3. The patient and his or her caregivers are then educated about proper wound care and prevention. They're taught how to care for wounds at home and receive information about nutrition and exercises that may aid in the healing process and prevent future wounds. For example, foot wound patients are given instruction about protective measures for their feet and walking, and sometimes special shoes that protect the feet and relieve pressure are prescribed.

Who has chronic wounds and who's at risk for developing them?

  • Approximately seven million Americans suffer from chronic wounds.
  • Persons with diabetes are at greatest risk. Up to 15 percent of the estimated 17 million Americans with diabetes may suffer from chronic wounds, most commonly non-healing foot sores, which can lead to amputation.
  • The remaining percentage of chronic wounds result from pressure ulcers, peripheral neuropathy (nerve disorders affecting the hands or feet), peripheral vascular disorders (impeding blood circulation), arterial occlusive disease (causes blockages in major arteries), radiation, osteomyelitis (infection of the bones), and insect bites.

What are the complications of chronic wounds?

  • Chronic wounds can lead to serious infections, gangrene, and in the worst cases, amputation.
  • Every year, more than 82,000 people with diabetes have amputations. (The risk of leg amputation alone is 15 to 40 times greater in persons with diabetes.)

Since chronic foot wounds are particularly common, especially among patients with diabetes, what steps can be taken to prevent them?

  • Don't go barefoot, either indoors or outside.
  • Use moisturizer for excessively dry feet after bathing.
  • Avoid exposing your feet to extreme temperatures, such as hot sand or pavement. Wear sunscreen on your feet. Don't use hot water bottles or heating pads when your feet are cold; instead, wear loose-fitting socks.
  • Trim nails straight across without rounding the corners.
  • Don't cut or remove corns or calluses yourself or use commercial products without first consulting your physician.
  • Wear comfortable shoes that fit well. Don't wear open-toed shoes, heels, or sandals.
  • When you need to purchase new shoes, try them on later in the day, when your feet are enlarged slightly to ensure they'll fit comfortably. Don't wear new shoes more than two hours at a time until you break them in.
  • Don't wear shoes without socks or stockings, and avoid socks and stockings with seams and 100 percent synthetics. Instead, wear cotton and cotton blends, and change socks daily.
  • If a non-healing foot sore occurs, consult your physician.

Where else can I learn more about chronic wounds online?

Hyperbaric care

Maps and directions

Referring physician information

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