Non-healing Wounds and how to Address them

Non-healing wounds can be a challenging aspect of patient care for nurses, physical therapists, and occupational therapists. These wounds can significantly impact a patient’s quality of life and require specialized strategies for effective healing. 

But what causes non-healing wounds, and how do we address them?

Here, we explore the underlying causes, characteristics, various strategies to assist in the healing of non-healing wounds. 

What Causes Wounds That Won’t Heal?

non-healing wound

Non-healing wounds can have multiple underlying causes, making a comprehensive assessment crucial. Here are some common factors that contribute to delayed wound healing:

  1. Poor Circulation: Reduced blood flow to the wound area can impede the delivery of oxygen and nutrients necessary for healing.
  2. Infection: Bacterial, viral, or fungal infections can compromise the body’s natural healing processes, leading to delayed wound healing.
  3. Chronic Diseases: Conditions such as diabetes, peripheral vascular disease, or autoimmune disorders can impair the body’s ability to heal wounds effectively.
  4. Nutritional Deficiencies: Inadequate intake of essential nutrients, especially protein, vitamins (A, C, and E), and minerals (zinc and iron), can hinder wound healing.

What Do You Call a Wound That Never Heals?

A wound that fails to heal over an extended period is often referred to as a chronic or non-healing wound. These wounds typically exhibit delayed or stalled healing progress despite appropriate interventions and time.

Signs of Unhealed Wounds:

Recognizing the signs of unhealed wounds is essential for prompt intervention and management. Some common indicators include:

  1. Persistent Redness: The wound bed remains red or inflamed beyond the expected healing timeframe.
  2. Excessive Drainage: Continued or increased wound exudate that fails to diminish over time may suggest impaired healing.
  3. Lack of Granulation Tissue: Absence or insufficient growth of granulation tissue, which is vital for wound healing, can be an indication of a non-healing wound.
  4. Increasing Wound Size: Wounds that continue to expand or fail to reduce in size despite appropriate care require further evaluation.

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How to Treat a Non-Healing Surgical Wound:

Addressing non-healing surgical wounds necessitates a comprehensive approach. Here are some strategies commonly employed by healthcare professionals:

  1. Wound Debridement: Debridement, the removal of dead or non-viable tissue, is crucial for promoting wound healing. It helps eliminate barriers to
  2. Advanced Dressings: Utilizing appropriate wound dressings, such as hydrogels, foams, or collagen dressings, can create an optimal healing environment by regulating moisture, promoting granulation tissue formation, and protecting against infection. Protecting the skin around where a wound is likely to occur is also key to in ongoing prevention.
  3. Negative Pressure Wound Therapy (NPWT): NPWT involves applying controlled suction to the wound, enhancing blood flow, reducing edema, and promoting healing by facilitating the removal of excess fluid and debris. 
  4. Offloading and Pressure Redistribution: In cases where pressure ulcers contribute to non-healing wounds, implementing offloading techniques, specialized cushions, or therapeutic support surfaces can relieve pressure and promote healing. 
  5. Including lymphatic drainage: When you see a large non-healing wound, lymphatic drainage may not be the first priority springing to mind. But including manual lymphatic drainage as well as compression can have a huge effect on a previously non-healing wound, and make all the difference to a wound that may have been resistant to other treatments for quite some time. If the wound bed is not receiving ‘healthy’ circulation, it is unlikely to be able to heal well. Lymphatic management will promote healthy circulation as well as removal of unhelpful molecules.
  6. UpskillingMaking sure that you own hands-on skills, wound care education and knowledge are up to date is crucial. Updates and changes to the current management of wound happen frequently, and as a nurse or physical/occupational therapist, it definitely behooves you to stay on top of current trends. Taking our Wound Care course is a great place to get started, as it focuses in on strategies that you will be able to implement, outside-the-box thinking, and ultimately practical treatment options for any therapist. See why it gets 5 stars- every time!

Healing non-healing wounds requires a multidimensional approach, considering factors like circulation, infection control, chronic diseases, and proper nutrition. By employing strategies such as debridement, advanced dressings, NPWT, and pressure redistribution, nurses and therapists can play a vital role in facilitating the healing process. Continual education and access to relevant resources further empower healthcare professionals to provide the best care possible for patients with non-healing wounds.

Remember, each patient is unique, and individualized treatment plans should be developed in collaboration with the interdisciplinary healthcare team. By staying updated with the latest advancements in wound care and applying evidence-based strategies, nurses and therapists can make a significant impact on improving the healing outcomes for their patients.

Want to upskill in Wound Care? Check out our incredibly popular and well-received course, A Comprehensive Guide to Wound Care: Tools for the Everyday Clinician, available as a live, virtual, or even self-paced offering for 7 Contact Hours/CEUs!

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